Pyloroplasty
Peptic ulcer - pyloroplasty; PUD - pyloroplasty; Pyloric obstruction - pyloroplastyPyloroplasty 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).
The pylorus is a thick, muscular area. When it thickens or its opening narrows, food cannot pass through.
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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 so it becomes wider.
- Closes the cut in a way that keeps the pylorus open. This allows the stomach to empty.
Surgeons can also do this surgery using a laparoscope. A laparoscope is 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.
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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 opening.
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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
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Before the Procedure
Tell your surgeon:
- If you are or could be pregnant
- What medicines you're taking, including medicines, supplements, or herbs you bought without a prescription
During the days before your surgery:
- You may be asked to stop taking blood thinners. These include NSAIDs (aspirin, ibuprofen), vitamin E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and clopidogrel (Plavix).
- Ask your surgeon which drugs you should still take on the day of the surgery.
- If you smoke, try to stop. Ask your health care provider for help quitting.
On the day of your surgery:
- Follow instructions about not eating and drinking.
- Take the medicines your surgeon told you to take with a small sip of water.
- Arrive at the hospital on time.
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After the Procedure
After surgery, the health care team will monitor your breathing, blood pressure, temperature, and heart rate. Many people can go home within 24 hours.
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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.