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 • Reasons for Procedure • Possible Complications • What to Expect • Call Your Doctor

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

Reasons for Procedure

The pylorus sphincter can become narrowed. The condition is called pyloric stenosis. It can cause severe symptoms such as nausea, vomiting, and dehydration. Narrowing of the pylorus can be caused by scarring from ulcers. It can also be caused by a mass, such as cancer.

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

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have pyloroplasty, your doctor will review a list of possible complications, which may include:

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

Factors that may increase the risk of complications include:

Smoking
Bleeding disorder
Advanced age
Prior surgeries in the abdomen
Obesity, malnutrition, or dehydration
Cardiac or respiratory disease

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 medicines with your doctor.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as warfarin (Coumadin)
- Clopidogrel (Plavix)

Anesthesia

Your surgery will be done using general anesthesia. You will be in a deep sleep.

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 block pain during the procedure. After the surgery, you will feel pain. You will receive medicine to relieve pain.

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

During your hospital stay, 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. Ask your doctor about when it is safe to shower, bathe, or soak in water. Be sure to follow your doctor's instructions.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding or any discharge from the incision site
Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
Pain that you cannot control with the medicines 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

In case of an emergency, call for medical help right away.

RESOURCES:

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

Family Doctor.org
http://familydoctor.org/online/famdocen/home.html

CANADIAN RESOURCES:

Canadian Medical Association Journal
http://www.cmaj.ca

REFERENCES:

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
Last Updated: 11/26/2012

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