CPT® Code 47362

The CPT® Code 47362 refers to the management of liver hemorrhage through the re-exploration of a hepatic wound for the removal of packing. This procedure is typically indicated when there has been significant bleeding from the liver, necessitating surgical intervention to control the hemorrhage. The process begins with a midline abdominal incision, which allows the surgeon to gain access to the liver and the surrounding abdominal cavity. During this exploration, the surgeon assesses the extent of the liver injury and checks for any potential damage to adjacent organs, blood vessels, or nerves. The falciform ligament is divided to facilitate access, and the overlying bowel is retracted to provide a clear view of the liver. To adequately expose the liver, the right and left peritoneal ligaments are incised, and the triangular ligaments are excised. This mobilization of the liver is crucial for a thorough examination and treatment of the hepatic injury. The procedure may involve various techniques for repairing liver wounds, including simple or complex suturing, ligation of intrahepatic blood vessels and bile ducts, and the use of hemostatic agents to control bleeding. If bleeding persists after initial repair efforts, a selective hepatic artery ligation may be performed. In cases where packing has been used to control bleeding, the abdomen is re-opened one to two days post-repair to remove the packing and inspect the liver for any signs of ongoing bleeding or necrosis. This re-exploration is critical for ensuring that the liver is healing properly and that any additional debridement can be performed if necessary. The abdomen is then closed in layers, ensuring proper healing and recovery.