Scientific paper| Volume 124, ISSUE 3, P331-333, September 1972

Measurement of the diameter of the pylorus in man

Part I. Experimental project for clinical application
  • Nikolaos Salessiotis
    Reprint requests should be addressed to Professor Salessiotis, 75 Evrou Street, Athens T 610, Greece.
    Athens, Greece
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  • Author Footnotes
    1 From the Surgical Clinic A of the Medical Faculty of Athens University and the Department of Surgery of the Private Hospital “ASCLEPEION OF ATHENS,” Athens, Greece.
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      The results of experimental work to measure the diameter of the pylorus during full function are presented. This measurement was undertaken in the belief that adherence to the strict physiologic diameter of the pylorus in anastomoses between the stomach and duodenum or jejunum would serve to prevent the so-called dumping syndrome.
      We found that this diameter never exceeded 1.9 cm which, we believe, represents the normal threshold for gastric emptying without functional disturbances from the intestine. Any increase in this diameter threshold involves a rather precipitous emptying of the stomach contents into the intestine, which is the initiating factor in the dumping syndrome.
      This principle was applied in more than 1,300 gastroenteroanastomoses after gastrectomy between 1954 and 1971, with the diameter never exceeding the limit of 2 cm. The technic of the anastomosis and the surprisingly good functional results will be presented in the second part of this work.
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        • Krook SS
        Extremely narrow gastroenterostomy in Billroth II gastrectomy as dumping prophylaxis.
        Acta Chir Scand. 1970; 136: 64