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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 October;18(5):427-30
Y-V Pyloroplasty. A technique obsolete but useful
Safioleas M. C., Moulakakis K. G., Kountouras J., Kostakis A.
Aim. Pyloroplasty associated with vagotomy has been used in the past for the therapy of peptic ulcer disease and hemorrhagic gastritis, in order to produce less deformity in the pyloric region. In order to gain more insight into this surgical terchnique, the records of twenty-three patients operated on with this technique are reviewed.
Methods. Twenty-three patients underwent pyloroplasties with Y-V technique. The surgical need for pyloroplasty in this group of patients included pyloric stenosis (4 patients), bleeding duodenal ulcer (8 patients), perforated ulcer (7 patients), intractable ulcer (3 patients) and stress ulcer (1 patient).
Results. All patients had an uneventful postoperative course. The results were excellent in all patients except for three cases. The complications resulting from this surgical procedure were gastric outlet obstruction in one patient and early postoperative rebleeding in two patients. The patient with gastric obstruction due to pyloric stenosis underwent antral resection and a gastroduodenal anastomosis was performed. The patients with rebleeding were successfully managed with conservative measures.
Conclusions. The Y-V pyloroplasty permits the resection of anterior ulcers, involving little dissection as no extended mobilization of the duodenum is required. In case of intense hypertrophy of the pyloric sphincter, the technique may be an alternative surgical procedure providing maximal channel size with minimal operating time. Moreover is a simple and safe technique.