CPT® Code 47420

Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty

The procedure described by CPT® Code 47420 involves a surgical intervention known as choledochotomy or choledochostomy, which is performed to address issues within the common bile duct. This procedure is typically indicated for patients suffering from acute cholecystitis, particularly those who are critically ill and unable to undergo more definitive surgical options, such as a cholecystectomy. During the procedure, an incision is made in the common bile duct to allow for exploration, drainage, or removal of any calculi (stones) that may be obstructing the bile flow. The terms choledochotomy and choledochostomy refer to the surgical opening of the bile duct, with choledochotomy specifically indicating the incision made in the duct itself, while choledochostomy refers to the creation of an opening for drainage purposes. The procedure may also involve a cholecystotomy, which is the incision into the gallbladder to remove stones and ensure proper bile flow. The surgical team utilizes various instruments, such as forceps and irrigation tools, to effectively remove stones from the bile duct and the intrahepatic ducts. If necessary, a T-tube may be placed to facilitate continuous drainage, ensuring that any remaining stones can be managed appropriately. This procedure is critical for alleviating symptoms and preventing further complications associated with bile duct obstruction.