Hepato-gastroenterology · 2005
Results from the application of extramucous valvular pyloroplasty.
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Radev Dobrin, Kostov Daniel, Bozov Hristo
Аннотация
BACKGROUND/AIMS: A method for pyloroplasty with complete reconstruction of the pyloric area is presented.
METHODOLOGY: The method had been preliminarily tested in dogs and then clinically applied in 28 peptic ulcer patients. The task was solved by pneumatic preparation and ring-shaped removal of pylorus musculature within a zone of 3.0-3.5 cm the integrity of the underlying mucous muff was preserved and the latter was invaginated into the lumen. Thus a circular mucous-submucous valve in the region of the gastroduodenal ligament was formed. Due to the preserved anatomical integrity, innervation and blood supply of this mucous-submucous layer after its pleating created a zone wide like a normal pylorus between the stomach and duodenum.
RESULTS: The duration of the postoperative follow-up was between 6 months and 10 years. The newly created valve looked like a normal pylorus. It was 6 mm thick and 11 mm high and protruded into the lumen. The submucous layer was doubled, richly vascularized, and the muscular layers were continuous.
CONCLUSIONS: This operative technique could successfully be applied in gastric surgery for preventing the dumping syndrome and gastric reflux when pyloroplasty is required.
METHODOLOGY: The method had been preliminarily tested in dogs and then clinically applied in 28 peptic ulcer patients. The task was solved by pneumatic preparation and ring-shaped removal of pylorus musculature within a zone of 3.0-3.5 cm the integrity of the underlying mucous muff was preserved and the latter was invaginated into the lumen. Thus a circular mucous-submucous valve in the region of the gastroduodenal ligament was formed. Due to the preserved anatomical integrity, innervation and blood supply of this mucous-submucous layer after its pleating created a zone wide like a normal pylorus between the stomach and duodenum.
RESULTS: The duration of the postoperative follow-up was between 6 months and 10 years. The newly created valve looked like a normal pylorus. It was 6 mm thick and 11 mm high and protruded into the lumen. The submucous layer was doubled, richly vascularized, and the muscular layers were continuous.
CONCLUSIONS: This operative technique could successfully be applied in gastric surgery for preventing the dumping syndrome and gastric reflux when pyloroplasty is required.