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.
Abstract
This research deals will the declared production planning operation in the general company of planting oils, which have great role in production operations management who had built mathematical model for correct non-linear programming according to discounting operation during raw materials or half-made materials purchasing operation which concentration of six main products by company but discount included just three products of raw materials, and there were six months taken from the 1st half of 2014 as a planning period has been chosen . Simulated annealing algorithm application on non-linear model which been more difficulty than possible solution when imposed restric
... Show MoreThe indirect monetary policy tools led to financial stability for the period being studied through the use of indicators of financial stability (aggregate) to show the effect of the foreign reserves of the Central Bank of Iraq and its indirect instruments in achieving financial and economic stability, especially after the significant decline in oil prices and dependence of the Iraqi economy on Oil (rent) and lower reserves of the Central Bank of Iraq after 2014 and now compared to previous years, the goal of this research is to achieve financial stability according to selected indicators and achieve an optimal monetary policy to achieve the development goals of The economic policy in the country. Standard models were used to test
... Show MoreObjectives: To identify the impact of the brain consensus model on the acquisition of Arabic grammar concepts among students in the fourth grade, methodology: The pilot curriculum was used, and a partial control pilot design was adopted. There were 30 female students in the pilot group, 30 female students in the control group, and the two researchers were statistically rewarded among the two groups' students in some variables and used appropriate statistical means to analyse the results, including the test for two independent samples, the square (c2) and the Alpha Kronbach equation.Results: The pilot group outperformed the control group. The results showed that there is a significant statistical difference at the indicative level (0.05) for
... Show MoreThe current study aims to develop a proposed educational program based on augmented reality (AR) technology, in addition to assessing its effectiveness in developing research and historical imagination skills of the Humanities Track's female students at the secondary stage, as well as assessing the correlative and predictive relationships between the amount of growth for the two dependent variables. To achieve this, a secondary school in the city of Makkah Al-Mukarramah was chosen, and an available random sample of (30) female students from the study population was selected. The quasi-experimental approach was followed by this study, particularly one group design. In addition, two tools were used to collect study data, namely: a test of
... Show MoreIn his life, a person engages in different types of verbal and actual dispositions that result in various effects, some of which are necessary and not valid, such as selling, and some are not necessary for one of the two contracting parties, such as a mortgage or both, such as lending and agency. However, there are some actions that are sometimes necessary and not necessary at other times, such as a gift that indicates in its simplest sense. Owning money for another without compensation, it is one of the doors of benevolence and benevolence, and it is one of the attributes of perfection with which God, may He be glorified and exalted be He, described Himself. - And if this analogy is the difference - and distanced himself from greed, the
... Show MoreThis study attempts to focus on there lation ship between employment policies andsocietal changesinIraq.Theconstruction ofoperational policyincommunitiesin crisis remains fraught with challenges and risks, especially in countries that have longoutstanding conflict sand crises, it is important in this context to achieve those policy and build the foundations of human security and poverty alleviation, unemployment, to find effective ways to help the community to achieve stability and reduce the risk of renew edorrepeat the cycleofviolence-butthatwouldrequirearadicalrethinking, including rethinking the way evaluating therisksandchallengesand management.And thatsuchaprojectshouldbe based ona clear roadmap, andthevisionsofdevelopmentanda clea
... Show MoreBackground: Obesity has become one of the most important public heath problems all over the world.An epidemic of obesity is affecting children and adolescents across the developed and developing countries in recent years. As the prevalence of obesity increased, so did the prevalence of co morbidities like metabolic and endocrine diseases.Objectives: To overview obesity clinical features and the prevalence of associated co morbidities in children and adolescents attended the obesity researches and therapy center in Alkindy medical collage.Type of study: This is a cohort observational studyMethods : Obese child and adolescents aged 4-15year attended the obesity research and therapy unit in AL Kindy medical collage from the 1st of September
... Show More