CPT® Code 48547

Duodenal exclusion with gastrojejunostomy for pancreatic injury, as described by CPT® Code 48547, is a surgical procedure performed in response to traumatic injuries affecting the pancreas, particularly when there is involvement of the pancreatic duct and duodenum. This procedure is essential for managing complications arising from such injuries, as it aims to divert gastric contents away from the duodenum. The diversion is crucial to allow for the healing of both the duodenum and the pancreatic duct, which may be compromised due to the trauma. The surgical approach typically involves making a subcostal or midline incision in the abdomen to gain access to the affected organs. Once the pancreas and duodenum are exposed, the surgeon inspects them for any damage. A gastrotomy, or incision in the stomach, is performed to facilitate the procedure. The pylorus, which is the opening from the stomach into the duodenum, is then grasped, clamped, and sutured closed to prevent gastric contents from entering the duodenum. Subsequently, a loop gastrojejunostomy is created by dividing the jejunum, which is then anastomosed to the stomach. This surgical alteration effectively reroutes gastric flow away from the duodenum for a period ranging from several weeks to months, allowing the injured areas to heal properly. After the procedure, the abdomen is irrigated, drains are placed to manage any potential fluid accumulation, and the abdominal incision is closed around these drains. It is important to note that the exclusion suture in the pylorus is designed to eventually open, allowing the gastrojejunostomy to functionally close without the need for further surgical intervention.