CPT® Code 47605

The procedure described by CPT® Code 47605 refers to a cholecystectomy performed with cholangiography. In this surgical intervention, the gallbladder is surgically excised through an open technique, which involves making an incision in the upper abdomen, typically located in the right subcostal region. This approach allows the surgeon to access the gallbladder and surrounding structures effectively. During the procedure, retractors are utilized to hold the incision open, providing a clear view of critical anatomical landmarks such as the hepatoduodenal ligament, the gallbladder itself, and the triangle of Calot, which is the area where the cystic duct and the common bile duct meet. The surgical team meticulously dissects the tissue down to the cystic duct's junction with the common duct, ensuring that surrounding structures are preserved. The dissection continues to the cystic artery, which supplies blood to the gallbladder. Once the gallbladder is adequately mobilized, it is detached from the hepatic bed, and the cystic duct is ligated to prevent bile leakage. The cystic artery is also carefully dissected, doubly ligated, and divided to complete the removal of the gallbladder. After the gallbladder is excised, the surgeon may place drains to facilitate fluid drainage from the surgical site before closing the incision. Additionally, if intraoperative cholangiography is performed, a small catheter is inserted into the cystic duct, and a contrast medium of 10-20 ml is instilled. This allows for the visualization of the bile ducts using fluoroscopy, which can help identify any potential complications or abnormalities in the biliary tree during the procedure. This comprehensive approach ensures that the cholecystectomy is performed safely and effectively, with the added benefit of cholangiography to enhance surgical outcomes.