CPT® Code 47120

The procedure described by CPT® Code 47120 refers to a hepatectomy, specifically a partial lobectomy of the liver. In this surgical intervention, the physician removes a portion of either the right or left lobe of the liver. The operation begins with an incision typically made in the right subcostal area, which may extend into the left subcostal region or even cranially over the xiphoid process, depending on the specific requirements of the surgery. This approach allows the surgeon to access the liver effectively. During the procedure, the right rectus muscle is transected, and the oblique muscles are split to facilitate access to the liver. Additionally, the medial portion of the left rectus muscle is also transected to ensure adequate exposure. Once the liver is accessible, the ligaments that are attached to the segment of the liver designated for removal are severed, allowing for the mobilization of the liver. The inferior vena cava and the hepatic veins located above the liver are carefully dissected to avoid damage to these critical structures. The arteries supplying the segment of the liver being excised are identified and ligated to prevent excessive bleeding. Similarly, the veins are dissected and divided as part of the resection process. A line of transection is marked on the liver segment using electrocautery, which helps to delineate the area for removal. The liver parenchyma is then divided using surgical scissors and blunt clamp dissection techniques, leading to the removal of the targeted liver segment. After the segment is excised, the vascular and biliary structures are ligated to ensure hemostasis and prevent bile leaks. The surgeon meticulously examines the raw surface of the liver for any signs of bleeding or bile leaks, controlling any bleeding through coagulation methods. If biliary leaks are detected, they are managed through clipping and suture ligation. Finally, the surgical site is irrigated, drains may be placed as necessary, and the incision is closed with sutures to complete the procedure.