74301 Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (List separately in addition to code for primary procedure)

Name of the Procedure:

Cholangiography and/or Pancreatography; Additional Set Intraoperative, Radiological Supervision, and Interpretation

Summary

Cholangiography and pancreatography are imaging procedures used to visualize the bile ducts and pancreatic ducts, respectively. The terms refer to X-ray-based techniques for capturing detailed images of these ductal systems, typically with the aid of a contrast agent. The "additional set" indicates an extra series of images taken during surgery, which requires radiological supervision and interpretation.

Purpose

These procedures are primarily used to detect blockages, stones, strictures, or other abnormalities in the bile and pancreatic ducts. The goal is to provide clear images to guide treatment, often intraoperatively, to ensure the patient has the best surgical outcome.

Indications

• Jaundice
• Abdominal pain suggesting biliary or pancreatic issues
• Suspected bile duct stones or strictures
• Pancreatitis or pancreatic tumors
• Abnormal liver function tests
• Previous inconclusive imaging studies

Preparation

• Fasting for at least 6-8 hours before the procedure
• Medication adjustments as advised by the healthcare provider
• Pre-procedure blood tests and liver function tests
• A pre-procedural consultation with the surgical and radiology teams

Procedure Description

1. Patient receives anesthesia or sedation.
2. A catheter is inserted into the bile or pancreatic duct.
3. A contrast agent is injected to highlight the ducts on X-rays.
4. Intraoperative X-ray images are taken.
5. An additional set of images is captured if required for further detail.
6. The radiologist interprets the images in real-time to assist the surgical team.
7. The catheter is removed, and the procedure concludes.

Duration

The procedure typically takes about 1-2 hours.

Setting

Usually performed in a hospital's surgical suite or operating room equipped with radiological imaging devices.

Personnel

• Surgeon
• Radiologist
• Anesthesiologist
• Surgical nurses
• Radiology technician

Risks and Complications

• Infection
• Bleeding
• Allergic reaction to the contrast agent
• Pancreatitis
• Damage to the bile or pancreatic ducts
• Radiation exposure

Benefits

• Accurate diagnosis of ductal abnormalities
• Enhanced surgical outcomes with real-time imaging guidance
• Rapid identification and management of issues
• Immediate interpretation of images

Recovery

• Monitoring in a recovery area post-procedure
• Pain management with medications
• Instructions on wound care if any incisions were made
• Follow-up appointments for further assessment
• Typical full recovery within a few days to a week

Alternatives

• Ultrasound
• Magnetic Resonance Cholangiopancreatography (MRCP)
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
• Pros of alternatives: Non-invasive options such as ultrasound and MRCP
• Cons of alternatives: May not provide as detailed information as intraoperative imaging

Patient Experience

During the procedure, the patient will be under anesthesia or sedation and should not feel pain. Post-procedure, the patient may experience some discomfort at the catheter insertion site, managed with prescribed pain medications. Normal activities can often be resumed within a few days, but specific restrictions will be provided based on individual recovery progress.