CPT® Code 47300

The procedure described by CPT® Code 47300 refers to the marsupialization of a cyst or abscess located in the liver. This surgical intervention is specifically designed to treat fluid-filled sacs (cysts) or collections of pus (abscesses) that can develop within the liver tissue. The term 'marsupialization' indicates that the cyst or abscess is surgically opened and a pouch is created to facilitate the drainage of its contents, which may include fluid and debris. This approach helps to prevent the recurrence of the cyst or abscess by allowing continuous drainage. The procedure typically involves making an incision in the right subcostal area, which may extend into the left subcostal region or even up towards the xiphoid process, depending on the size and location of the cyst or abscess. During the operation, the surgeon transects the right rectus muscle and splits the oblique muscles to gain access to the liver. The medial portion of the left rectus muscle may also be transected to provide adequate exposure. Once the cyst or abscess is accessed, it is opened and drained, and the anterior wall of the cyst is resected. The remaining wall is carefully inspected for any biliary orifices, which are sutured to prevent bile leakage. Additionally, any biliary vessels that drain into the cyst or abscess are ligated to minimize complications. Finally, the cut edges of the remaining wall are sutured back to the adjacent skin edges, creating a pouch that remains open to allow for ongoing drainage and healing.