The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves:
A. Cutting the vagus nerve.
B. Removing the distal portion of the stomach.
C. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid.
D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.
Correct Answer: D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.
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.
Option A: A vagotomy involves cutting the vagus nerve. A vagotomy is a type of surgery that removes all or part of the vagus nerve. This nerve runs from the bottom of the brain, through the neck, and along the esophagus, stomach, and intestines in the gastrointestinal (GI) tract.
Option B: A subtotal gastrectomy involves removing the distal portion of the stomach. Gastrectomy is a surgery that’s done to treat stomach cancer. During gastrectomy, the surgeon may remove part or all of the stomach. A subtotal gastrectomy includes removing the part of the stomach with cancer, nearby lymph nodes, and possibly parts of other organs near the tumor.
Option C: A Billroth II procedure involves removal of the ulcer and a large portion of the tissue that produces hydrochloric acid. There are many variations on the procedure, but they generally involve resection of the diseased portion of the distal stomach and a side-to-side anastomosis of the residual stomach to jejunum through the transverse mesocolon. It can be performed with either an antecolic or a retrocolic anastomosis.
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