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Pyloroplasty—Adult(Pyloric Stenosis Repair; Pyloromyotomy)

Pronounced: py-LOR-oh-plah-stee, py-LOR-ik stuh-NOH-sis, py-LOR-oh-MY-ah-ta-me

Definition

Pyloroplasty is a surgery to correct a narrowing of the pyloric sphincter. The pylorus is a muscular area that forms a channel between the stomach and intestine. Normally, food passes easily from the stomach into the intestine through this sphincter.

Pyloric Sphincter—Pyloroplasty

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Reasons for Procedure

The pylorus sphincter can become narrowed, usually from an enlargerment of the muscle. The condition is called pyloric stenosis . It can cause severe symptoms such as nausea, vomiting, and dehydration . Narrowing of the pylorus can be the result of scarring from ulcers, a hiatal hernia, a mass, such as cancer, or inflammatory diseases.

Pyloric stenosis may be a serious condition. Pyloroplasty is often necessary to treat it.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Infection
  • Damage to intestines
  • Hernia formation at the incision site
  • Chronic diarrhea

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

What to Expect
Prior to Procedure
  • Do not eat or drink anything after midnight.
  • Your doctor may order a laxative. This will help you clean out your intestines.
  • If you have diabetes, discuss your medications with your doctor.
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
Anesthesia

Your surgery will be done using general anesthesia . You will be asleep.

Description of Procedure

An incision will be made in the upper part of your abdomen. The pylorus will be exposed. Your doctor will cut through the pyloric muscle. The sphincter will be sewn back together in a way that will make the opening wider. The abdominal muscles will be sewn back together. The skin will be closed with stitches or staples.

If your pyloroplasty is done because you have an ulcer, other procedures may be done at the same time.

Immediately After Procedure

After the surgery, you will be monitored in a recovery area for about 1-2 hours.

How Long Will It Take?

About 1-2 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care
At the Hospital

You will gradually return to a normal diet. Before you go home, a nurse will teach you how to take care of your surgical incision.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding or any discharge from the incision site
  • Persistent nausea and/or vomiting
  • Pain that you cannot control with the medications you were given
  • Cough, shortness of breath, or chest pain
  • Severe abdominal pain or vomiting blood
  • Dark-colored, tarry stools or blood in the stool

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
http://www.cag-acg.org

Health Canada
http://www.hc-sc.gc.ca

References:

Dimitrios M, et al. Laparoscopic Pyloroplasty in Idiopathic Hypertrophic Pyloric Stenosis in an Adult. JSLS. 2000 Apr-Jun; 4(2): 173–175.

Feldman M. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 7th ed. Philadelphia, PA: Saunders; 2002.

Khatri VP, Asensio JA. Operative Surgery Manual. 1st ed. Philadelphia, PA: WB Saunders; 2003.

Townsend CM. Sabiston Textbook of Surgery. 17th ed. St. Louis, MO: WB Saunders; 2004.

Yamada T. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2003.

6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.



Last reviewed November 2012 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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