Background: Acute cholecystitis is common surgical
problem, which was treated previously by conservative
treatment .Later early open has been introduced as an
alternative to interval for treatment of acute cholecystitis.
Early open was found to be a safe, successful with
comparable postoperative complication rate. With the
advent of laparoscopy laparoscopic have been used for
chronic cholecystitis and became the first line of
treatment. New reports have shown that laparoscopic can
be used as an alternative to open for surgical treatment of
acute cholecystitis.
Objectives: to compare the success, safety of early
laparoscopic versus early open as a primary treatment of
acute cholecystitis.
Methods: out of 68 patients were treated for clinical
acute cholecystitis between January 2002 and February
2004 in the department of surgery, at Al – Kindy teaching
hospital. A total of 62 patients underwent early for acute
cholecystitis as soon as possible after diagnosis. The
preferred preoperative imaging technique was ultrasound.
30 (48.3%) of the operations were attempted
laparoscopically, whereas the remaining 32 patients
(51.7%) underwent initial open .
Results: The mean operative time for the open cases
was 75 minutes versus 60 minutes for the laparoscopic
group. There was no perioperative mortality in either
group. The incidence of conversion to open was 10% (3
patients). Surgical complications related to laparoscopic
and open occurred in 2 (6.6%) and 3 (9.3%) cases,
respectively. There was no difference between the open
and laparoscopic groups in regard to the major
postoperative complications.
Conclusion: The current study shows that early
(whether performed by open or laparoscopically) is a
safe and effective treatment for acute cholecystitis. Low
conversion rates can be maintained with strict guidelines
for appropriate patient selection, adequate experience,
and proper laparoscopic technique.
Applications of quantitative methods, which had been explicit attention during previous period (the last two centuries) is the method of application sales man or traveling salesman method. According to this interest by the actual need for a lot of the production sectors and companies that distribute their products, whether locally made or the imported for customers or other industry sectors where most of the productive sectors and companies distributed always aspired to (increase profits, imports, the production quantity, quantity of exports. etc. ...) this is the part of the other hand, want to behave during the process of distribution routes that achieve the best or the least or most appropriate.
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... Show MoreRecently, Knowledge Management Systems (KMS) consider one of the major fields of study in educational institutions, caused by the necessity to identify their knowledge value and success. Hence, based on the updated DeLone and McLean’s Information Systems Success Model (DMISSM), this study set out to assess the success of the Perceived Usefulness of Knowledge Management Systems (PUKMS) in Iraqi universities. To achieve this objective, the quantitative method is selected as the research design. In total, 421 university administration staff members from 13 Iraqi private universities were conducted. This study highlights a number of significant results depending on structural equation modeling which confirms that system, information, and s
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