Incision of pylorus and 1st part of duodenum with reapproximation of anterior duodenal and pyloric margins; used to aid drainage of gastric antrum after selective or truncal vagotomy or vagal nerve interruption with esophagogastrectomy. Procedure is not indicated in duodenal scarring or inflammation or if duodenotomy is made to locate gastrinomas. Full Kocher maneuver should be performed in conjunction with this procedure. Inverted U-shaped incision is made with double-layer closure; 7Ð10-day gastric decompression is required postop.