The primary determinant of mortality after ECF repair is a failed operation leading to recurrence of the fistula. Risk factors for ECF recurrence include inflammatory bowel disease, fistula located in the small intestine, an interval of 36 weeks or longer between diagnosis and operation, and resection with stapled anastomosis.
FOR A SAMPLE OF 100 HIGH SCHOOL GRADUATES EMPLOYED IN AN AIRCRAFT PLANT, TEACHERS, WORK HABITS AND COOPERATION RATINGS, ABSENTEEISM, AND GRADE-POINT DATA WERE OBTAINED FROM HIGH SCHOOL TRANSCRIPTS AND RELATED TO WORK-PERFORMANCE CRITERIA OF SUPERVISORY RATINGS, ABSENTEEISM, AND TARDINESS RECORDS. SIGNIFICANT RELATIONSHIPS WERE OBTAINED BETWEEN THE HIGH SCHOOL PREDICTORS AND THE WORK-PERFORMANCE CRITERIA.
Hepatobiliary disease, although rare, may present during pregnancy with potential complications for mother and fetus. We present two cases of choledochal cysts and one case of a hepatic adenoma diagnosed in gravid patients. All three patients had acute events or failed medical management and were successfully treated with open resection, excision, or reconstruction during the second or third trimesters of pregnancy without requiring blood transfusions or tocolytic therapy. Although conservative treatment may be indicated in select patients due to the risk of underlying disease, we recommend surgical treatment preferably in the second trimester. With diligent intra- and postoperative management, pregnant patients can safely proceed with major hepatobiliary surgery.
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