0FT78ZZ
Resection Hepatic Duct, Common to No Qualifier with No 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 | T Resection |
| Body Part | 7 Hepatic Duct, Common |
| Approach | 8 Via Natural or Artificial Opening Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection covers the complete removal of a hepatobiliary or pancreatic organ or anatomically distinct portion, without replacing it with a graft or device. The most familiar example is cholecystectomy, the complete removal of the gallbladder, typically performed for symptomatic gallstones, chronic inflammation, or gallbladder cancer. Other examples include total pancreatectomy and complete removal of an anatomically whole lobe of the liver when disease affects the entire segment.
These procedures are chosen when disease, such as cancer, severe infection, or irreversible organ damage, involves an entire anatomically distinct body part and leaving any of it behind would not resolve the underlying problem. Because the liver and pancreas perform essential metabolic and digestive functions, surgeons carefully weigh how much can be safely removed before turning to resection of a whole part rather than a partial excision.
Anatomy & Axis Detail
Hepatic Duct, Common
The common hepatic duct forms at the confluence of the right and left hepatic ducts and travels alongside the portal vein and hepatic artery within the hepatoduodenal ligament before joining the cystic duct to become the common bile duct, making it a critical and vulnerable landmark during hilar dissection. It is resected for hilar cholangiocarcinoma, benign strictures unresponsive to endoscopic management, or choledochal cysts involving this segment, procedures that carry meaningful risk of injuring adjacent vasculature given the duct's close anatomic relationships. Because removing this duct interrupts the sole conduit for bile leaving the liver, reconstruction with a Roux-en-Y hepaticojejunostomy is essentially mandatory afterward. Resection coding applies when the ductal tissue itself is excised, as opposed to procedures that merely dilate or bypass an obstruction.
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.
Coding & Documentation
For Resection to apply, the documentation must show that an entire anatomically distinct body part, such as the whole gallbladder, an entire hepatic lobe, or the whole pancreas, was removed, not just a margin or lesion. When only a portion of an organ is taken, such as a wedge of liver tissue or the pancreatic tail alone, the case should instead be coded as an excision, a distinction that trips up coders regularly. Pathology and operative reports should be cross-referenced to confirm the full extent of what was removed and whether any organ tissue remained in the patient.