CPT® Code 43850

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The procedure described by CPT® Code 43850 involves the revision of a gastroduodenal anastomosis, specifically a gastroduodenostomy, without the performance of vagotomy. A gastroduodenostomy is a surgical connection made between the stomach and the duodenum, which is the first part of the small intestine. This procedure is typically indicated when there are complications at the site of the previous anastomosis, such as strictures or perforations. During the revision, the abdomen is surgically opened to allow for direct inspection of the anastomosis site. The specific steps taken during the revision depend on the underlying issue that necessitated the procedure. For instance, if a stricture is present, the muscular wall at the anastomosis may be incised longitudinally to relieve the narrowing, followed by a transverse repair of the stricture. In cases where a perforation has occurred, sutures are used to repair the damaged area. It is important to note that this particular code does not involve vagotomy, which is a procedure that entails cutting the vagus nerve to reduce acid production in the stomach, a step that is included in the related CPT® Code 43855. After the necessary revisions are made, the vagus nerve is identified and freed from surrounding tissues, and drains may be placed in the abdomen as required before closing the incision. This comprehensive approach ensures that the complications at the anastomosis site are effectively addressed while maintaining the integrity of the surrounding structures.