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.
Of the importance of the concept of ownership of real estate as the basic basis from which various projects are launched in various economic, tourism, and urban areas .... The need to research the diagnosis of real estate reality went astray in the difficulties, which played a decisive role in the process of urban development.
This leads us to the research problem of the difficulty of implementing urban development plans in many cases due to the absence of a clear methodology for organizing and modernizing the ownership of real estate and its coordination with the management of urban land and to achieve the objective
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The process of soil classification in Iraq for industrial purposes is important topics that need to be extensive and specialized studies. In order for the advancement of reality service and industrial in our dear country, that a lot of scientific research touched upon the soil classification in the agricultural, commercial and other fields. No source and research can be found that touched upon the classification of land for industrial purposes directly. In this research specialized programs have been used such as geographic information system software The geographical information system permits the study of local distribution of phenomena, activities and the aims that can be determined in the loca
The research abstract included introduction and the importance of the research, also included display of the problem represented by weakness for the players when performing some of the basic skills in badminton and the shuttle not reaching to the back corners of the court which gives the player the opportunity to win through applying the pressure on the opponent and make him away from the control center(T) which definitely required level of a collection muscular strength contributed in performance perhaps this related to a number of reasons related with weakness in physical changes especially explosive and characterized by speed forces for the badminton players and be acquainted with them and knowing the extent of their effect in performanc
... Show MoreTraining has occupied a leading position in a large number of developed and developing countries alike in order to develop the skills of workers in line with the changes and developments of the era, including monitoring compliance in banks, which is one of the most important jobs in banking work to trailing and monitor the bank’s compliance with laws, regulations and instructions in order to achieve its goals Therefore, the problem of this research focuses on the following question: What is the role of training in enhancing banking compliance at the present time? In order to clarify the relationship between the main and sub-research variables, two main hypotheses and three sub-hypotheses were formulated for each hypothesis, and t
... Show MoreThis thesis aims to show the effects of the development of the traditional manual system of the tax accounting process to the electronic system by the activation of the tax identification numbers (TINs) mechanism. The impact of this development is facilitating the tax accounting process, tax fraudand thus increasing the tax outcome.To prove the research hypothesis, an electronic system was designed based on income tax report, estimation note of individuals, in additional to using Adobe Dreamweaver application to write PHP, HTML, Javascript, and CSS web languages to implement the proposed system. The research reached a set of conclusions, the most important of which is; not enough the communication methods between the Genera
... Show Moreتشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه
... Show MoreThis research aims to examine the relationship between learning organization and behavior of work teams. The variable of the learning organization took four dimensions depending on the study (sudhartna & Li, 2004): Common cultural values , communication, knowledge transfer and the characteristics of workers. The behavior of teams was identified on the basis of realizing of the respondents of their organization to work as a team where the research relied concepts applied in the study (Hakim , 2005) , and chose to research the case of a service organization for the study and relied on four dimensions of coordination , cooperation , sharing of information , the performance of the team, and was a curriculum approach and des
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The research has discussed the public relations as dependent variable of its branch dimensions( confidence , commitment, control and satisfaction ) and the governmental service quality as independent variable of its branch dimensions (response, dependency, emphasis, tangibility and sympathy), and the research problem has represented by weakness of service quality presented to the customers dealing with company, which is observed via field co-existence of the researcher, where he observe that the quality presented in the company services, are inappropriate with the customers expectations level, also there is weakness of attention and recognition by the