Pyloric drainage: techniques and controversies

Esophagectomy for malignancy is commonly performed using a gastric conduit for the neoesophagus. Controversy remains as to the role of a prophylactic pyloric drainage procedure at the index operation to mitigate the risk of developing postoperative delayed gastric emptying (DGE) and gastric outlet obstruction (GOO). There is conflicting evidence in the literature that pyloric drainage procedures are useful, and there remains no consensus on best practice within the thoracic surgery community. If pyloric drainage is to be done during esophagectomy, options include endoscopic dilation, injection of botulinum, pyloromyotomy, and pyloroplasty.