title: Results from the application of extramucous valvular pyloroplasty.
abstract: OBJECTIVE
  A method for pyloroplasty with complete reconstruction of the pyloric area is presented.
  
  
  METHODS
  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.
authors.affiliation: Clinic of General Surgery, Medical University, Varna, Bulgaria.
authors.forename: Dobrin
authors.initials: D
authors.lastname: Radev
authors.forename: Daniel
authors.initials: D
authors.lastname: Kostov
authors.forename: Hristo
authors.initials: H
authors.lastname: Bozov
mesh_terms: D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004381:Duodenal Ulcer / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011708:Pylorus / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography