Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
סיכום
המשבר הוא מצב מצוי רב בחברת המדינות אחרי המלחמות והשינויים הגדולים במאה העשרים, ומשבר הזהות הוא ממשברי המאה העשרים שזכה בהתעניינות רבה בכל תחומי המדעים האנושיים, ומהם תחום הספרות. ובספרות העברית היה הסופר א. ב. יהושע מהסופרים החשובים שהתעניין בנושא הזהות בישות הציונית, הוא התווכח בנושא ביצירותיו, ראיוניו ורוב הכנסים התרבותיים והפוליטיים שנכח אותם, הוא השתמש באסכולה ספרותית מאו
... Show MoreThe present paper focuses on studying a rhetorical form often used in Spanish linguistic discourse .It also examines the study two sides (theoretical and practical), the concept of metaphor, the most important modern school that deals with this issue, the development of this technique and its relationship with other intellectual ideologies, and the role metaphor plays in interpreting the meaning of the linguistic discourse especially in conveying political message. The study allows the formulation and the creation of a conceptual picture for the purposes of metaphor in the linguistic discourse used in Spanish press. It investigates discursive models from the Spanish press,
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The most important results in this research: the success of the author in the employment of the Islamic history in the formation of the first American legend, Columbus legend, through the selection of the right thoughts to establish his American National theory. The author compared between the Andalusia experience and the Arab occupation to Spain and the American conquest of the new
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В статье рассмотрены отыменные предлоги в системе литических единиц русского языка с позиций функционального и семантического аспектов. Репрезентирована специфика функциониров
... Show MoreThe purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training
... Show MoreThe aim of this research is to identify the strengths and weaknesses of organizational health in the Iraqi Central Handball Federation from the point of view of those who manage the implementation of the annual curriculum, and adopt a descriptive approach in the method of studying the case. This is based on a sample of administrators of the Iraqi Handball Federation curriculum [trainers, governors, members, president, the 138 members of the Central Federation's Administrative Authority, the President, members of the sub-federations of the sports market (2021/2022) selected deliberately by 100% and then divided into statistical analysis sample (30), reconnaissance sample (10), and application sample (98)]. The regulatory health questionnaire
... Show MoreThe importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on one hypothesis in two ways that the use of genetic engineering on maize seeds works to: one - increase production efficiency of seeds and savings in agricultural inputs. 2. Rationalize the costs of examining and planting maize seeds. In order to calculate the costs will be based on the cost system based on activities ABC. The research
... Show MoreThe aim of the research to highlight the calendar of the most important tools used by the Central Bank of Iraq, in the implementation of the function of supervisory oversight, to verify the stability of the banking system, and protect the funds of shareholders, and depositors in general and the absence of any raises the risks of default and financial failure in particular, for commercial banks. The most important flaws and weaknesses in these tools, in the early detection of the risks of continuity in a timely manner, The study concluded a set of conclusions, including the weakness of the tools used in the performance of the function of supervisory oversight in detecting cases of default and financial failure in the early time as well as
... Show MoreThe continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel
Translation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.
Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a
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