CPT® Code 48154

Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy

The CPT® Code 48154 refers to a surgical procedure known as a proximal subtotal pancreatectomy with near-total duodenectomy, choledochoenterostomy, and duodenojejunostomy, specifically a pylorus-sparing, Whipple-type procedure, performed without a pancreatojejunostomy. In this complex operation, the head of the pancreas, which is the proximal portion, is surgically removed along with a significant portion of the bile duct and nearly the entire duodenum, while preserving a small segment of the duodenum, typically 3-4 cm in length. This procedure is indicated for various conditions affecting the pancreas and surrounding structures, such as tumors or chronic pancreatitis. The surgical approach involves making a subcostal or midline incision in the abdomen to access the pancreas and duodenum. The surgeon carefully mobilizes these structures, identifies critical vascular landmarks such as the superior mesenteric vein, and dissects the pancreas from its surrounding attachments. The procedure is characterized by the removal of the affected pancreatic tissue and associated structures, followed by the reconstruction of the gastrointestinal tract to maintain continuity. The absence of a pancreatojejunostomy distinguishes this procedure from similar ones, as it does not involve the anastomosis of the pancreatic duct to the jejunum. Instead, the remaining duodenum is connected to the jejunum through a gastrojejunostomy, ensuring that digestive continuity is preserved post-surgery.