CPT® Code 38382

The procedure described by CPT® Code 38382 involves the suture and/or ligation of the thoracic duct through an abdominal 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 from the cisterna chyli, located at the level of the second lumbar vertebra, and ascends through the abdomen, passing anterior to the vertebral bodies. As it enters the thoracic cavity, it crosses from the right side to the left at approximately the fourth or fifth thoracic vertebra before 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 abdominal approach for this procedure allows the surgeon to directly access the thoracic duct, locate the site of the leak, and perform necessary repairs. 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 health issues.