Special Technique of Pyloroplasty (with Special Choice of Method)
The plastic surgery involved in a structurally and functionally appropriate pyloroplasty consists of the creation of a pylorus ring of normal function and of diameter 1.5 to 2 cm (thumb and index finger test = Hegar 19). With the classical procedures (Heinicke-Mikulicz, Jaboulay, Finney) it is practically impossible to produce an actively opening and closing concentric pylorus. The plastic operation must be adapted to the individual case. In contrast to SPV, the technique cannot be standardized; in our experience 5 typical forms have proved their value as being best able to meet the contingencies in the pylorusduodenal area. Because of the great variability of form in the pylorus area, it can only be said that the best plastic operation will be that which most closely approaches the restoration of a normal pylorus function with respect to emptying on the one hand and avoidance of reflux on the other. As to the question whether a pyloroplasty is necessary at all or may be omitted, this should in no circumstances be regarded as an alternative solution. Too many practical observations and experimental results testify to the great significance of drainage to permit an apodictical viewpoint to be adopted here.
KeywordsShrinkage Histamine Dexon Gall Achalasia
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