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Definition

Pyloroplasty is surgery to widen the opening in the lower part of the stomach (pylorus) so that stomach contents can empty into the small intestine (duodenum) more easily.

The pylorus is a thick, muscular area. When it thickens or its opening narrows, food cannot pass through normally.

Description

The surgery is done while you are under general anesthesia (asleep and pain free).

If you have open surgery, the surgeon:

• Makes a large surgical cut in your belly to open the area.
• Cuts through some of the thickened muscle where your stomach empties so it becomes wider.
• Closes the cut in a way that keeps the pylorus open. This allows the stomach to empty more easily.

Surgeons can also do this surgery using a laparoscope. A laparoscope has a tiny camera that is inserted into your belly through a small cut. Video from the camera will appear on a monitor in the operating room. The surgeon views the monitor to do the surgery. During the surgery:

• Three to five small cuts are made in your belly. The camera and other small tools will be inserted through these cuts.
• Your belly will be filled with gas to allow the surgeon to see the area and perform the surgery with more room to work.
• The pylorus is operated on as described above.

Why the Procedure Is Performed

Pyloroplasty is used to treat complications in people with peptic ulcers or other stomach problems that cause a blockage of the stomach outlet opening.

Risks

Risks for anesthesia and surgery in general are:

• Reactions to medicines or breathing problems
• Bleeding, blood clots, or infection

Risks of this surgery include:

• Damage to the intestine or nearby organs
• Hernia
• Leakage of stomach contents
• Long-term diarrhea
• Malnutrition
• Vomiting
• Dumping syndrome (when food moves too rapidly from the stomach to the duodenum)

Before the Procedure

If you are a smoker, you should stop smoking several weeks before surgery and not start smoking again after surgery. Smoking slows recovery and increases the risk of problems. Tell your surgeon or health care provider if you need help quitting.

Tell your surgeon or nurse if:

• You are or could be pregnant
• You are taking any medicines, including medicines, supplements, or herbs you bought without a prescription

During the week before your surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you should still take on the day of surgery.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.

After the Procedure

After surgery, your health care team will monitor your breathing, blood pressure, temperature, and heart rate. Many people can go home within 24 hours.

Outlook (Prognosis)

Most people recover quickly and completely. The average hospital stay is 2 to 3 days. It's likely you can slowly begin a regular diet in a few weeks.

References

Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 53.

Mahvi DA, Mahvi DM. Stomach. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 49.

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