CPT® Code 38380

The procedure described by CPT® Code 38380 involves the suture and/or ligation of the thoracic duct through a cervical approach. The thoracic duct is a critical component of the lymphatic system, serving as the primary channel for lymph fluid, which is essential for immune function and fluid balance in the body. It typically originates in the cisterna chyli, located at the level of the second lumbar vertebra, and ascends through the abdominal region, positioned anteriorly to the vertebral bodies. As it progresses into the thoracic cavity, the duct crosses from the right side to the left at approximately the fourth or fifth thoracic vertebra, ultimately draining into the left jugular-subclavian venous junction. Due to its delicate structure, the thoracic duct is vulnerable to injury, which can result in lymphatic leaks. The cervical approach for this procedure involves making a supraclavicular incision on the left side to access the thoracic duct, allowing the physician to locate and repair the site of the leak. This may involve suturing the duct or ligating it above and below the injury site to prevent further leakage. Post-repair, a gauze pad is placed over the area to monitor for any ongoing leakage, and additional reinforcement may be applied using a sealant. This procedure is essential for addressing complications arising from thoracic duct injuries, ensuring proper lymphatic drainage and preventing further complications.