CPT® Code 43620

The procedure described by CPT® Code 43620 refers to a total gastrectomy with esophagoenterostomy. This surgical intervention involves the complete removal of the stomach, which is accessed through an upper midline abdominal incision. The procedure begins with an exploration of the abdominal cavity to assess the surrounding organs and structures. The stomach is then mobilized, and clamps are strategically placed above the gastroesophageal junction and below the gastroduodenal junction to facilitate the transection of the esophagus and duodenum. The esophagus is cut just distal to the clamp, while the duodenum is transected proximal to the clamp, allowing for the complete excision of the stomach. Following the removal, an esophagoenterostomy is performed, which involves bringing a segment of the small intestine, typically the duodenum, up to the esophageal stump. The final step of this procedure includes suturing the esophagus and duodenum together in an end-to-end configuration, thereby creating a new pathway for food to pass from the esophagus into the small intestine. This procedure is critical for patients with severe gastric conditions, as it effectively removes the diseased organ and establishes a new digestive route.