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What to Know About Pyloroplasty

Medically Reviewed by Dan Brennan, MD on June 12, 2021

Pyloroplasty is a surgery that widens your pylorus. When your pylorus is thick or narrowed, it’s difficult for food to pass through.

Why Is Pyloroplasty Done?

Your pylorus is a valve between your stomach and small intestine. It usually holds food in your stomach.

Your pylorus closes when food and liquid need to be digested in your stomach. It then opens to let liquid and food pass into your small intestine. 

A pyloroplasty can help treat several conditions that may cause your stomach opening to be blocked, such as:

  • Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis. This is when your pylorus thickens abnormally. It usually affects newborns.  
  • Refractory gastroparesis. This is when your stomach takes longer than usual to empty out its contents.
  • Scarring from ulcers
  • Cancer

Pyloroplasty may also be done at the same time as a vagotomy. This procedure removes part of your vagus nerve to help with peptic ulcer disease. This nerve controls your digestive system.

Types of Pyloroplasty

There are a few types of pyloroplasty:

  • Heineke-Mikulicz pyloroplasty. A cut is made lengthwise to make your pylorus wider. This is the most common type of pyloroplasty.
  • Jaboulay pyloroplasty. In this procedure, your doctor will create a new connection between your stomach to your small intestine (duodenum) without cutting into your pylorus.
  • Finney pyloroplasty. This also connects your stomach directly to your duodenum but with the incision to your pylorus. ‌This procedure is rarely done today.

There are a few other types of procedures that are related to the pylorus:

Pyloromyotomy. During a pyloromyotomy, your doctor will make a cut in the wall of your pylorus. The lining of your pylorus pushes through the cut. This creates a channel from your stomach to the small intestine.

Chemical pyloroplasty. In this procedure, botulinum toxin is injected into the pylorus. 

Pyloric dilation. The pylorus is dilated (expanded) with a balloon, dilator, or a finger. This procedure can also be done nonsurgically.

How Is Pyloroplasty Done?

Pyloroplasty can be done as open surgery or as laparoscopic surgery

Open surgery. For open surgery, this will be done under general anesthesia. This means you’ll be asleep during the surgery. 

The general steps for this procedure are: 

  1. Your surgeon will make a cut in the upper part of your stomach. This will expose your pylorus. 
  2. A cut will be made in the muscle of your pylorus. 
  3. Your surgeon will sew your sphincter together in a way that makes the opening wider.
  4. They will then sew your abdominal muscles back together and close your skin with staples or stitches. 

This surgery may take 1 to 2 hours. You may stay in the hospital for 1 to 3 days. 

Laparoscopic pyloroplasty. This type of surgery uses a device called a laparoscope. A laparoscope is a long thin tube that’s passed through a small cut in your abdomen. 

The general steps for the laparoscopic surgery are:

  1. You’ll be given a general anesthetic to prevent pain and relax your muscles during the surgery. 
  2. A small cut will be made near your navel, where the laparoscope will be inserted.
  3. Your abdomen will be inflated to make it easier to see your organs. 
  4. Your doctor will then continue with the pyloroplasty.

In most cases, you may leave the hospital about 4 hours after laparoscopy.

Studies have shown that laparoscopic surgeries are generally safe. They also have a lower likelihood of complications compared with open surgeries.

Risks of Abdominal Surgery

All surgeries have some risks. Some risks of abdominal surgery include: 

Dumping Syndrome

Dumping syndrome is when your food moves too quickly from your stomach to your small intestine. About 1 in 10 people who have stomach surgery get dumping syndrome.

There are two types of dumping syndrome:

Early dumping syndrome. This happens 30 minutes after eating a meal. Symptoms include: 

  • Diarrhea
  • Nausea
  • Feeling bloated
  • Cramping and pain in your abdomen
  • Flushing or reddening of face, neck, or upper chest
  • An irregular or fast heartbeat
  • Fainting or lightheadedness
  • Feeling tired

Late dumping syndrome. This happens 1 to 3 hours after you eat. Symptoms are caused by low blood sugar (hypoglycemia). They include: 

  • Feeling jittery or shaky
  • Trouble concentrating
  • Sweating
  • Feeling tired
  • Fainting or lightheadedness
  • A fast or irregular heartbeat
  • Weakness

Early dumping syndrome will likely resolve itself within 3 months. Diet changes may help improve your symptoms. These changes may include:

  • Increasing your fiber intake
  • Adding more protein and whole grains. Limit foods that are high in sugar such as candy and soda. 
  • Limiting dairy products or avoiding them completely. The lactose in dairy products may make your symptoms worse.
  • Drinking 6 to 8 cups of fluids a day. But drink most of these between meals. 
  • Eat 5 or 6 small meals instead of 3 big ones. 

If changes to your diet don’t help, your doctor may recommend medication or surgery.

Show Sources

SOURCES:

Cleveland Clinic: “Laparoscopy,” “Pyloric Stenosis (HPS).”

International Surgery Journal: “Comparative study of outcome and complications of surgical management of benign gastric outlet obstruction.”

Mayo Clinic: “Dumping syndrome,” “Pyloromyotomy.”

Medscape: “Pyloroplasty,” “Vagotomy.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Dumping Syndrome.”

Winchester Hospital: “Pyloroplasty—Adult.”

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