Finney’s pyloroplasty consists in making an anastomotic opening between the pyloric end of the stomach and the first part of the duodenum, and will be best appreciated from the accompanying illustrations ([Figs. 537], [538], [539], [540] and [541]).
Fig. 541
Finney’s pyloroplasty: anterior suture completed. (Bergmann.)
The opening can be made as extensively as desired, and it is not easy to see how it can be subsequently reduced to a degree disadvantageous to the patient.
Gastro-enterostomy may be needed in non-malignant cases, because of fixation and the impossibility of bringing the pyloric end of the stomach out sufficiently to make operation feasible. It will be required in cases of cancer when pylorectomy is not indicated. The method of making gastro-enterostomy will be described later.
Operations for Dilatation of the Stomach.
—Gastroplication consists of taking a number of “tucks” in the stomach wall and thus reducing its capacity. The purpose and the method of the operation will be appreciated by the accompanying illustrations. These operations are mainly indicated, however, in the absence of pyloric stenosis, for if a free opening be afforded from the dilated stomach into the upper bowel the gastric enlargement will usually be spontaneously reduced ([Figs. 542] and [547]).
Gastropexy is a term applied to fixation of the stomach to the anterior abdominal wall. It has been thus stitched up in a few cases when greatly dilated or depressed into the lower abdomen. [Fig. 548] illustrates the method. The stomach has also been suspended by shortening the gastrohepatic and gastrophrenic ligaments, as illustrated in [Fig. 549].
Fig. 542