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 study aims to measure the level of academic stress in the e-learning environment in three areas, students and their dealing with classmates, dealing with the professor and technical skills, and the nature and content of the curriculum among graduate students in the College of Education at King Khalid University during COVID-19 pandemic. This study was descriptive in nature (survey, comparative). The sample consisted of (512) male and female graduate students in the master's and doctoral programs. The Academic Stress Scale in the E-learning Environment designed by Amer (2021) was used. The results indicated a high level of academic stress among graduate students in the e-learning environment. The study also found that there were stati
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This study is an attempt to investigate the semantic and syntactic features of English and Arabic verbs of eating. After surveying the literature on the meaning of verbs in both languages, three chapters address the major issues in this subject. The problem to be investigated in this study can be summarized in the following points: 1. The overlapping of semantic and syntactic features within the category of verbs of eating in English and Arabic. 2. Which semantic classification is more accurate and through which method? 3. Which classification, the semantic or the syntactic, is more important? This study hypothesized the following: 1. The semantic features are more influential in analyzing the category of verbs of eating than the syntactic
... Show MoreThe present paper sheds light on the psychological structure of Simha Bin Zion’s A Broken Soul. After reviewing the biography of the storyteller, it is clear that the hero of the rebellious character in the story of (A Broken Soul) is the writer himself. The storyteller directly begins to depict his psychological sufferings in his childhood days. He tells a story full of sadness and refusal of the neglect he suffered in his childhood. It is obvious that the early five years of Samha bin Zion’s life is considered a period of conflict that participated in the formation of his individual identity. The story represents an outlet for a hidden secret world buried under the layers of his consciousness. It deals with
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After deciding the methodology of the study that ,in one hand ,performs the goals of the study , and achieving a suitable theoretical framework to present the concepts of businesses, environments and the leadin
... 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 importance of this research comes from the possibility of achieving positive interaction between accounting and tax through the interest in setting accounting standards and adapting them to local tax legislation, as the adoption of the application of the international standard (IAS 12) for income taxes helps to measure and determine the base for income tax and may lead to an increase in the tax outcome. Through the reliance of enterprises on many accounting bases, and that the tax administration in Iraq depends on the element of personal judgment in determining the tax base, which leads to lack of objectivity in determining the tax outcome, as the impact of the accounting standard (IAS 12) on the tax base and tax outcome is one of th
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