Definition

The pylorus is a muscular valve that forms a channel between the stomach and duodenum, a section of intestine that is located just before the the small intestine. Normally food passes easily from the stomach into the duodenum through the valve.

The pylorus can become narrowed. This condition is called pyloric stenosis . Pyloric stenosis can cause severe symptoms such as nausea, vomiting, and dehydration . Children can develop pyloric stenosis early in life, often by the age of 12 weeks, usually due to thickening of the pyloric muscle rather than an ulcer.

Pyloroplasty is a surgery to correct pyloric stenosis.

Pyloric Sphincter--Pyloroplasty

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Parts of the Body Involved

  • Abdomen
  • Stomach
  • Duodenum
  • Small Intestine

Reasons for Procedure

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


Risk Factors for Complications During the Procedure

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

What to Expect

Prior to Procedure

  • Do not eat or drink anything after midnight.
  • Your doctor may order a laxative for you to take to cleanse your intestine.
  • Do not use aspirin or other NSAIDs (nonsteroidal anti-inflammatory medications such as Motrin or Advil) for one week before your surgery.
  • If you are diabetic, discuss your medications with your doctor.
  • If you are on blood-thinning medications, discuss them with your doctor.

Anesthesia

Your surgery will be done using general anesthesia. General anesthesia will put you in a deep sleep.

Description of the Procedure

You will be unconscious during the procedure. Your surgeon will make an incision in the upper part of your abdomen. The cut will go through the skin and muscle layers and down to the pylorus.

Your surgeon will then cut through the pylorus itself and sew it back together in a way that will make it larger. Then he or she will sew the abdominal muscles back together and close the skin incision with stitches or staples. Sometimes, especially in children, only the muscle itself is split (pyloromyotomy). This avoids opening the stomach.

If your pyloroplasty is performed because you have an ulcer, other procedures (such as a vagotomy) may be done at the same time as your pyloroplasty.

How Long Will It Take?

The surgery will take 1 to 2 hours. After the surgery, you will be monitored in a recovery area for another 1 to 2 hours.

Will It Hurt ?

During the surgery, you should feel no pain. After the surgery you will feel pain, but you will receive medication to relieve the pain.

Possible Complications

  • Bleeding
  • Infection
  • Hernia in the incision
  • Chronic diarrhea

Average Hospital Stay

The hospital stay for pyloroplasty is typically 1 to 3 days.

Postoperative 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.


Outcome

Complete recovery will take several weeks. If the surgery is successful, your symptoms should be relieved.


Call Your Doctor If Any of the Following Occurs

  • You vomit blood.
  • You pass black tar-like stools.
  • You have difficulty breathing.
  • You experience severe abdominal pain, nausea, or vomiting.
  • You notice signs of infection, such as fevers or chills.
  • You notice bleeding or drainage from a surgical wound.