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.
The present research aims to test the effect of cognitive complexity as an independent variable in organizational agility as a responsive variable among the leaders working at the headquarters of the Iraqi Petroleum Products Distribution Company.
To conclude a number of recommendations that contribute in the organizational agility in the company, and due to the importance of this research in public organizations and its notable role in community organizations. The research was carried out on a random sample of 101 individuals out of a total of 308, which represents the high leaders in the company (general managers, head of departments, and division officials). A questionnaire was used as information
... Show MoreIn this part of programme , different bacterial isolates mainly Salmonella spp, Shigella spp and Escherichia coli were used for antagonism with Saccharomyces boulardii under different conditions . S.boulardii was grown under aerobic conditions and antagonized with young overnight nutrient broth cultures of test bacterial isolates and other kept in refrigerator for a week after full growth . Young cultures were more susceptible to antagonistic effect of yeast compared to old cultures and on isolates grown on solid medium for 24 hr. S.boulardii grown under aerobic and microaerobic conditions and antagonized with overnight broth cultures of test bacterial isolates , The results revealed that aerobic cultures of yeast had more inhibito
... Show MoreThis research examines the issue of Internet banking services and their impact on customer's perceived value to know the potential of Iraqi commercial Banks to provide Internet banking services as well as determine the customer's level of perception of the value of such services. The research aims to demonstrate the effect that Internet banking services have on the customer's perceived value and to find how online banking services can be used to add value that the customer perceive. The main findings were that research sample banks don't have a sophisticated network of electronic Windows through which banking services are provided to allow customers to manage their accounts, and perform various operational operations through the
... Show MoreBrainstorming is one of the fundamental and necessary concepts for practising the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead To increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
... Show MoreBrainstorming is one of the fundamental and necessary concepts for practicing the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead to increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
... Show MoreThe aims of the research is to know the role of strategic to manage the human resources in enhancement the process of knowledge management in the Ministry of Transportation , In addition to the effects occurred on outcomes for both the managers and practitioners .
For the purpose of achieving the objectives of the research , the researchers designed a questionnaire that included (40 Points for collecting the primary data from the sample of the research which contained (51) indiviluals. In light of that, the data was to collect and analyzed and hypotheses were tested by using the (SPSS) Program, and a number of statistical techniques was used to attain the goal of the research such as the means , Sta
... Show MoreAbstract:
Witness the current business environment changes rapidly reflected on the performance of the facility wishing to stay , which is no longer style reaction enough to handle installations with their environment , and quickly began to lose its luster with the emergence of a message and the vision of contemporary business environment from a set of parts interacting with each other and the concept of behavioral includes all dimensions of performance, it is imperative to adopt a system installations influence variables and positive interaction through the development of strategic plans and the use of implementation and follow-up strategies to ensure the effectiveness of the method for meas
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