Significance of the Heineke-Mikulicz pyloroplasty in the treatment of gastric dilatation-volvulus. A prospective clinical study.

Abstract

Twenty-six dogs with gastric dilatation-volvulus (GDV) were stabilized medically, followed by tube gastrostomy and gastropexy. In 13 dogs, a Heineke-Mikulicz pyloroplasty was also performed. Complications and recurrences were monitored during the immediate postoperative period and for 5 to 31 months thereafter. Barium gastrograms and contrast radiographs of the stomach were evaluated at week 1 and months 5 to 31. Significantly fewer dogs without pyloroplasty had complications during the immediate postoperative period. There were no differences in the long-term complication rates. Radiographic evaluations of the width of the pylorus, the size of the stomach, and the rate of gastric emptying showed no differences between dogs with and without pyloroplasty at any evaluation period. The Heineke-Mikulicz pyloroplasty increased the immediate postoperative complication rate after surgical fixation of the stomach for the treatment of GDV. It did not appear to influence the long-term outcome of the surgical treatment of this disease. The Heineke-Mikulicz pyloroplasty is not recommended in the treatment of GDV unless pyloric outflow obstruction can be demonstrated.