Why is Pyloroplasty done with vagotomy?

Pyloroplasty is most commonly performed as a gastric drainage procedure that is adjunctive to vagotomy for peptic ulcer disease (PUD). (Truncal and selective vagotomy denervate the pylorus and requires pyloric drainage; highly selective vagotomy spares the pylorus and does not require a drainage procedure.)

Which is the purpose of Pyloroplasty?

Pyloroplasty is surgery to widen the opening in the lower part of the stomach (pylorus) so that stomach contents can empty into the small intestine (duodenum). The pylorus is a thick, muscular area. When it thickens, food cannot pass through.

What is Subdiaphragmatic vagotomy?

Subdiaphragmatic Approach (Standard method for rat) In the subdiaphragmatic approach, each of the main vagus nerve trunks is carefully isolated below the diaphragm from the surrounding connective tissue and overlying vasculature. A small (2-3 mm) section is excised from each of the isolated vagal nerve trunks.

Where is a Pyloroplasty performed?

A general surgeon usually performs a pyloroplasty under general anesthesia. It may be performed as an open surgery with a large incision in the abdomen or a laparoscopic surgery, which is less invasive with several smaller incisions.

What are the complications of pyloroplasty and vagotomy?

Vagotomy and pyloroplasty are associated with technical complications, the most important being rupture of the esophagus, splenic injury, leak at the pyloroplasty, and intra-abdominal bleeding.

What is the purpose of truncus vagotomy in humans?

Truncal vagotomy is performed to reduce the risk of ulcer recurrence and the duodenal and pyloric incision is closed transversely (Heineke–Mikulicz pyloroplasty). Abubaker Ali, Michael S. Nussbaum, in Shackelford’s Surgery of the Alimentary Tract, 2 Volume Set (Eighth Edition), 2019

How does truncal vagotomy affect gastric emptying?

Truncal vagotomy involves division of both anterior and posterior vagal trunks at the esophageal hiatus. This procedure results in denervation of the acid-producing mucosa of the gastric fundus as well as the pylorus and antrum, causing an alteration of normal pyloric coordination and impaired gastric emptying.

When to expect diarrhea after truncus vagotomy surgery?

Truncal vagotomy is associated with clinically significant diarrhea in 5% to 10% of patients. It occurs soon after surgery and usually is not associated with other GI or systemic symptoms, a fact that helps to distinguish it from dumping.