CPT® Code 48153

Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy

The procedure described by CPT® Code 48153 involves a complex surgical operation known as a proximal subtotal pancreatectomy with near-total duodenectomy, choledochoenterostomy, and duodenojejunostomy, commonly referred to as a pylorus-sparing Whipple-type procedure. This surgery entails the removal of the head, or proximal portion, of the pancreas, which is a vital organ involved in digestion and blood sugar regulation. Along with the pancreas, a significant portion of the duodenum, which is the first part of the small intestine, is excised, preserving only a small segment of 3-4 cm of the duodenum. Additionally, the procedure may include a pancreatojejunostomy, where the pancreas is surgically connected to the jejunum, the second part of the small intestine, to facilitate digestive processes. The surgical approach typically involves making a subcostal or midline incision in the abdomen to access the pancreas and surrounding structures. During the operation, the surgeon mobilizes the duodenum and the head of the pancreas, identifies critical vascular structures such as the superior mesenteric vein, and carefully dissects the pancreas from its attachments to the surrounding mesenteric vessels. The procedure is intricate, requiring precise dissection and anastomosis (surgical connection) of the pancreas and jejunum, as well as the bile duct to the jejunum, ensuring that the digestive system can function properly post-surgery. The careful removal of these structures and the subsequent reconnections are essential for the patient's recovery and long-term health outcomes.