Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary pr
CPT4 code
Name of the Procedure:
Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (e.g., fluoroscopy), and all associated radiological supervision and interpretation, each duct.
Summary
In layman's terms, this is a medical procedure where a small balloon is used to widen blocked or narrowed bile ducts. It is done using a needle inserted through the skin and guided by imaging technology to ensure accuracy.
Purpose
This procedure addresses blockages or narrowing in the bile ducts, which can cause symptoms such as jaundice, abdominal pain, and digestive issues. The goal is to improve bile flow from the liver to the small intestine, alleviating symptoms and preventing complications.
Indications
- Jaundice (yellowing of the skin or eyes due to bile buildup)
- Abdominal pain
- Cholangitis (inflammation of the bile ducts)
- Biliary stricture (narrowing of the bile ducts)
- Previous surgeries or diseases causing bile duct narrowing
Preparation
- Patients may need to fast (not eat or drink) for several hours before the procedure.
- Adjustments to current medications might be necessary, as instructed by the healthcare provider.
- Blood tests and imaging studies (like an ultrasound or CT scan) may be performed in advance to assess the bile ducts.
Procedure Description
- The patient is usually given a sedative or light anesthesia to help them relax.
- Using imaging guidance, a doctor inserts a thin needle through the skin into the bile duct.
- A wire is threaded through the needle into the narrowed or blocked area.
- A small balloon is then advanced over the wire to the affected area.
- The balloon is inflated to dilate (widen) the duct.
- Once the duct is adequately widened, the balloon and wire are removed.
- Imaging is used throughout to ensure precise placement and effectiveness.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
This procedure is typically performed in a hospital or outpatient surgical center equipped with imaging facilities.
Personnel
- Interventional radiologist (doctor specializing in imaging-guided procedures)
- Radiologic technologist
- Nurses
- Anesthesiologist or sedation nurse (if applicable)
Risks and Complications
- Bleeding
- Infection
- Bile leakage
- Injury to surrounding organs or tissues
- Allergic reaction to contrast dye used in imaging
Benefits
- Relief from symptoms caused by bile duct obstruction
- Improved digestion and liver function
- Prevention of further complications such as cholangitis or pancreatitis
Recovery
- Patients may need to stay in a recovery area for a few hours post-procedure.
- Pain at the insertion site is common and can be managed with medication.
- Instructions may include avoiding strenuous activities and monitoring for signs of infection.
- Follow-up appointments will be scheduled to check on the procedure's success and address any issues.
Alternatives
- Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
- Surgery to bypass the blockage
- Stent placement
- Each alternative has its own risks and benefits, and the best choice depends on the individual patient's condition and overall health.
Patient Experience
During the procedure, the patient might feel slight pressure but usually not significant pain, thanks to sedatives or anesthesia. Afterward, there might be some soreness at the insertion site, manageable with pain relief measures. Most patients can resume normal activities within a few days, but specific instructions will vary based on individual circumstances.