CPT® Code 47400

The procedure described by CPT® Code 47400 refers to a hepaticotomy or hepaticostomy, which involves surgical intervention on the liver. This procedure is performed through a midline abdominal incision that allows the surgeon to gain access to the liver. The falciform ligament, which is a fold of peritoneum that connects the liver to the anterior abdominal wall, is divided to facilitate exposure. Once the liver is accessible, the overlying bowel is retracted to provide a clear view of the liver. The right and left peritoneal ligaments are incised, and the right and left triangular ligaments are excised to further mobilize the liver for inspection. During this exploration, the surgeon looks for any signs of disease and assesses the condition of the liver and its associated structures. If an obstructed duct, either extrahepatic or intrahepatic, is identified, it is incised to allow for the drainage of bile. In cases where an intrahepatic calculus, or stone, is present, it is removed during this procedure. After addressing the issues with the duct, the incision may either be closed or a drain may be placed to facilitate further drainage. Finally, the abdominal incision is closed in layers to ensure proper healing and recovery.