0FL68DZ
Occlusion Hepatic Duct, Left to No Qualifier with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | F Hepatobiliary System and Pancreas |
| Operation | L Occlusion |
| Body Part | 6 Hepatic Duct, Left |
| Approach | 8 Via Natural or Artificial Opening Endoscopic |
| Device | D Intraluminal Device |
| Qualifier | Z No Qualifier |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
Occlusion procedures in this body system close off a duct, vessel, or opening within the liver, gallbladder, bile ducts, or pancreas so that fluid can no longer pass through it. This is most often performed on a bile duct or pancreatic duct that is leaking, diseased, or being deliberately sealed to redirect flow elsewhere, and less commonly on a blood vessel supplying these organs to stop bleeding or cut off circulation to a tumor.
Clinicians use this approach when a duct has been injured, is fistulizing to another structure, or needs to be sacrificed as part of a larger surgical plan, such as closing a stump left after partial removal of an organ. It may also be used to block blood flow into a tumor before resection, reducing bleeding risk during the main procedure.
The underlying idea is that the tubular structure remains anatomically in place but its lumen is deliberately shut, using clips, ligatures, embolic material, or a similar technique, rather than being cut out or repaired to restore normal function.
Anatomy & Axis Detail
Hepatic Duct, Left
The left hepatic duct collects bile from the left hemiliver and is somewhat more accessible surgically than the right duct given its more superficial course near the base of segment IV, which can make it a more common site for planned ligation during left-sided hepatic resections or repair of an isolated leak. Occlusion here may be achieved with a suture, clip, or extraluminal device, and is distinguished from excision or resection procedures in that the duct itself is closed off rather than removed. As with the right duct, variant anatomy is frequent, and preoperative or intraoperative cholangiography is often used to confirm that occluding the left duct will not inadvertently compromise drainage from unaffected segments.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
Device: Intraluminal Device
Intraluminal Device denotes a single device, such as a stent or occlusion device, positioned within the lumen of a tubular body part like a vessel, duct, or airway to maintain patency or occlude flow. It carries no drug coating or radioactivity, distinguishing it from the drug-eluting, radioactive, and bioactive intraluminal device values, and from Extraluminal Device, which sits outside rather than inside the lumen.
Coding & Documentation
Coders should look for explicit documentation that a duct or vessel was ligated, clipped, coiled, embolized, or otherwise closed off completely, and confirm which specific structure and approach was used, since embolization performed percutaneously through interventional radiology is coded differently in device and approach values than a duct tied off during open surgery. The device value must reflect whether an extraluminal device such as a clip or ligature, or an intraluminal device such as a coil, was left in place.
A frequent error is confusing partial narrowing or compression of a duct with true occlusion, when the intent and result must be complete closure of the lumen. Another common mistake is coding Occlusion when the vessel or duct was actually cut and its ends tied off as an incidental part of a different procedure, such as division during a resection, in which case the occlusion is not coded separately.