CPT® Code 47460

Transduodenal sphincterotomy or sphincteroplasty, as described by CPT® Code 47460, refers to a surgical procedure aimed at addressing dysfunctions of the sphincter of Oddi, which is a critical anatomical structure located at the junction where the pancreatic and bile ducts enter the duodenum. This sphincter functions as a one-way valve, facilitating the flow of bile into the duodenum while simultaneously preventing the reverse flow of intestinal contents into the bile ducts. When there is a presence of a stricture or a calculus (stone) within this area, it can lead to significant complications such as pancreatitis, biliary dilatation, and associated pain due to impaired bile drainage. The procedure can be performed either through an extraperitoneal approach, which involves a flank incision, or via an intraperitoneal approach through an abdominal incision. During the operation, the second part of the duodenum is accessed and incised to expose the sphincter of Oddi. The surgeon then identifies and divides the sphincter, extending the incision to the dilated portion of the bile duct to facilitate the removal of any obstructive stones. Following the removal of the stones, the common bile duct and duodenum are sutured together to restore continuity and function.