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Pyloroplasty

Peptic ulcer - pyloroplasty; PUD - pyloroplasty; Pyloric obstruction - pyloroplasty 

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).

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.

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.

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

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.

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.

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.

Related Information

Pyloric stenosis in infants
Duodenum

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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Review Date: 8/22/2022  

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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