Pyloroplasty

With pyloroplasty , OPS-2019 5-43 incision, excision and resection of the stomach , in which is Medicine an operation referred to, wherein a constricted pylorus is expanded to facilitate gastric emptying. The procedure is one of the drainage operations .

indication

Pyloroplasty may be indicated for:

Operating principle

The first documented operation was carried out in 1886 by Walter Hermann von Heineke , and in 1888 Johann von Mikulicz performed a similar operation for a gastric ulcer. According to these two surgeons, the procedure used is referred to as Heineke-Mikulicz pyloroplasty .

The procedure can be performed laparoscopically or openly.

There are different surgical techniques:

Pyloromyotomy according to Ramstedt - (Weber) : Longitudinal section of the ring-shaped musculature at the pylorus and expansion without opening the mucous membrane in hypertrophic pyloric stenosis in babies
Pyloroplasty according to Heineke-Mikulicz : Longitudinal incision and transverse closure of the pylorus, expansion plastic
Finney pyloroplasty : longitudinal section of the pylorus and the anterior end of the duodenum, side -to-side anastomosis (gastroduodenostomy)
Pyloroplasty according to Jaboulay : opening of the stomach above and the duodenum below the pylorus, anastomosis side-to-side with bypassing the pylorus

The procedure is often combined with a vagotomy .

An alternative, if indicated, can be balloon dilatation .

literature

S. Ono, F. Yano, M. Hoshino, N. Mitsumori, K. Sumiyama: Endoscopic pyloroplasty for adult hypertrophic pyloric stenosis associated with esophageal achalasia. In: VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy. Volume 3, number 1, January 2018, pp. 17-19, doi: 10.1016 / j.vgie.2017.09.005 , PMID 29905182 , PMC 5965723 (free full text).
T. White, PG Jackson: Chapter 16 - Vagotomy and Pyloroplasty. In: St. RT Evans (Ed.): Surgical Pitfalls. Prevention and Management. 2009, pp. 167-173, doi: 10.1016 / B978-141602951-9.50025-6
JG Randolph: YU advancement pyloroplasty. In: Annals of surgery. Volume 181, Number 5, May 1975, pp. 586-590, doi: 10.1097 / 00000658-197505000-00011 , PMID 1093489 , PMC 1345541 (free full text).

Individual evidence

↑ ^a ^b ^c Pschyrembel Online
↑ ^a ^b A. Hollinger, F. Largiadèr: Therapeutic principle: pyloroplasty. In: Blum AL, Siewert JR (Ed.) Ulcus therapy. Interdisciplinary gastroenterology. 1978, Springer, Berlin, Heidelberg Print ISBN 978-3-642-96457-2 Online ISBN 978-3-642-96456-5
↑ Heineke
^ Heinecke 1886, as stated by Maingot, R., In: Abdominal Operations, New York, Appleton-Century-Crofts, 1961; p. 169
↑ J. Mikulicz: For the operative treatment of the stenosing gastric oath. In: Arch.Klin.Chir. , Vol. 37, p. 79, 1888
↑ M. Bettex, N. Genton, M. Stockmann (Ed.): Pediatric surgery. Diagnostics, indication, therapy, prognosis. 2nd edition, Thieme (1982), ISBN 3-13-338102-4 .
^ V. Schumpelick: Surgery atlas . Georg Thieme Verlag, Stuttgart 2006, ISBN 3-13-140632-1 , p. 172 ( online ).
↑ JMT Finney: A new Method of Pyloroplasty, In: Bull. Johns Hopkins Hosp. , Vol. 13, pp. 155, 1902.
↑ M. Jaboulay: La Gastro-énterostomie, la jéjuno-duodénostomie, la résection du pylore, In: Arch.Prov.Chir., Vol. 1, p. 1,1892.
↑ emedicine
^ EW Swanson, SJ Swanson, RS Swanson: Endoscopic pyloric balloon dilatation obviates the need for pyloroplasty at esophagectomy. In: Surgical endoscopy. Volume 26, Number 7, July 2012, pp. 2023-2028, doi: 10.1007 / s00464-012-2151-5 , PMID 22398960 .

Web links

[pschy-1] Pschyrembel Online

[Hollinger-2] A. Hollinger, F. Largiadèr: Therapeutic principle: pyloroplasty. In: Blum AL, Siewert JR (Ed.) Ulcus therapy. Interdisciplinary gastroenterology. 1978, Springer, Berlin, Heidelberg Print ISBN 978-3-642-96457-2 Online ISBN 978-3-642-96456-5

[3] Heineke

[4] Heinecke 1886, as stated by Maingot, R., In: Abdominal Operations, New York, Appleton-Century-Crofts, 1961; p. 169

[5] J. Mikulicz: For the operative treatment of the stenosing gastric oath. In: Arch.Klin.Chir. , Vol. 37, p. 79, 1888

[6] M. Bettex, N. Genton, M. Stockmann (Ed.): Pediatric surgery. Diagnostics, indication, therapy, prognosis. 2nd edition, Thieme (1982), ISBN 3-13-338102-4 .

[7] V. Schumpelick: Surgery atlas . Georg Thieme Verlag, Stuttgart 2006, ISBN 3-13-140632-1 , p. 172 ( online ).

[8] JMT Finney: A new Method of Pyloroplasty, In: Bull. Johns Hopkins Hosp. , Vol. 13, pp. 155, 1902.

[9] M. Jaboulay: La Gastro-énterostomie, la jéjuno-duodénostomie, la résection du pylore, In: Arch.Prov.Chir., Vol. 1, p. 1,1892.

[10] ↑ emedicine

[11] EW Swanson, SJ Swanson, RS Swanson: Endoscopic pyloric balloon dilatation obviates the need for pyloroplasty at esophagectomy. In: Surgical endoscopy. Volume 26, Number 7, July 2012, pp. 2023-2028, doi: 10.1007 / s00464-012-2151-5 , PMID 22398960 .