CPT® Code 47360

The CPT® Code 47360 refers to the management of liver hemorrhage through a complex suture of a liver wound or injury, which may also involve hepatic artery ligation. This procedure is typically indicated in cases where there is significant bleeding from the liver due to trauma or surgical complications. The approach begins with a midline abdominal incision that allows for direct access to the liver. Surgeons explore the abdominal cavity to assess the extent of the liver injury and to check for any potential damage to surrounding organs, blood vessels, or nerves. The falciform ligament is divided to facilitate better exposure of the liver, and the overlying bowel is retracted to provide a clear view of the surgical field. During the procedure, packs are strategically placed above the liver to control bleeding. The right and left peritoneal ligaments are incised, and the triangular ligaments are excised to mobilize the liver effectively. This mobilization is crucial for exposing the hepatic artery and inferior vena cava, which are vital structures in the management of liver injuries. The liver wound is then carefully explored, and if necessary, a simple suture may be performed as indicated by CPT® Code 47350. However, in the case of CPT® Code 47360, a complex suture is utilized to repair the liver parenchyma and capsule, which may involve ligating intrahepatic blood vessels and bile ducts to control bleeding. If bleeding persists after these repairs, a selective hepatic artery ligation (SHAL) may be performed to further manage the hemorrhage. The liver is meticulously inspected for any signs of ongoing bleeding, ensuring that all necessary measures are taken to stabilize the patient’s condition.