TY - CHAP M1 - Book, Section TI - Pyloroplasty A1 - Hunter, John G. A1 - Spight, Donn H. A1 - Sandone, Corinne A1 - Fairman, Jennifer E. PY - 2018 T2 - Atlas of Minimally Invasive Surgical Operations AB - Laparoscopic pyloroplasty is most frequently performed as an adjunct to laparoscopic Nissen fundoplication for patients with gastroesophageal reflux and delayed gastric emptying, and may be used in conjunction with laparoscopic esophagectomy. Most frequently, pyloroplasty is indicated in esophagectomy, but may be indicated in iatrogenic gastric emptying disorders, where a previous operation has damaged the vagus nerve and created impaired gastric emptying. Because Nissen fundoplication, by itself, improves gastric emptying, pyloroplasty is reserved for those with profound emptying disorders manifest by residual food in the stomach on endoscopy and/or solid phase emptying that is twice the upper limit of normal (T½ ≥ 150 min). Other indications for pyloroplasty include gastroparesis outside the setting of fundoplication, or in a patient who has a very functional Nissen fundoplication but evidence of profound gastroparesis. For patients undergoing laparoscopic esophagectomy, pyloroplasty will improve gastric conduit emptying; however, it may accelerate gastric emptying sufficiently to create dumping and diarrhea, and may increase bile reflux. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1162530413 ER -