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Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy

BACKGROUND: Rouviere's sulcus is a 2–5 cm fissure on the liver between the right lobe and caudate process. The benefit of finding the Rouviere's sulcus during laparoscopic cholecystectomy is supported by the fact that the cystic duct and artery lay anterosuperior to the sulcus, and the com...

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Autores principales: Jha, Ashesh Kumar, Dewan, Rekha, Bhaduria, Kaustabh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015955/
https://www.ncbi.nlm.nih.gov/pubmed/33243952
http://dx.doi.org/10.4103/aam.aam_4_20
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author Jha, Ashesh Kumar
Dewan, Rekha
Bhaduria, Kaustabh
author_facet Jha, Ashesh Kumar
Dewan, Rekha
Bhaduria, Kaustabh
author_sort Jha, Ashesh Kumar
collection PubMed
description BACKGROUND: Rouviere's sulcus is a 2–5 cm fissure on the liver between the right lobe and caudate process. The benefit of finding the Rouviere's sulcus during laparoscopic cholecystectomy is supported by the fact that the cystic duct and artery lay anterosuperior to the sulcus, and the common bile duct (CBD) lays below the level of the Rouviere's sulcus. Hence, it can serve as an extrabiliary anatomical reference point during laparoscopic cholecystectomy to identify the location of CBD. MATERIALS AND METHODS: This prospective observational study was carried out on 99 patients during a period of 1 year. During laparoscopic cholecystectomy, Rouviere's sulcus was identified after retracting the fundus of the gallbladder toward the right shoulder. Its morphology in terms of open type, close type, or scar-like shapes was recorded, and if the CBD outline could be visualized, then its relation with the Rouviere's sulcus was noted. RESULTS: Among all 99 study patients, Rouviere's sulcus could be identified in 63 cases (63.63%), whereas it could not be seen in 36 cases (36.36%) (P < 0.007). It was of open type in 68.25% (43 cases), close type in 25.39% (16 cases), and scar like in 6.35% (4 cases) (P < 0.0001). The Rouviere's sulcus was found to be above the level of CBD line in 50 patients (79.36%) and at the same level in 11 patients (17.46%), and in two patients, (5.97%) CBD line could not be visualized. CONCLUSION: Identification of Rouviere's sulcus during laparoscopic cholecystectomy can serve as an additional reference point to avoid major bile duct injury. In the era of laparoscopy, it can be better visualized after creating the pneumoperitoneum and retracting the fundus of the gallbladder.
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spelling pubmed-80159552021-04-05 Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy Jha, Ashesh Kumar Dewan, Rekha Bhaduria, Kaustabh Ann Afr Med Original Article BACKGROUND: Rouviere's sulcus is a 2–5 cm fissure on the liver between the right lobe and caudate process. The benefit of finding the Rouviere's sulcus during laparoscopic cholecystectomy is supported by the fact that the cystic duct and artery lay anterosuperior to the sulcus, and the common bile duct (CBD) lays below the level of the Rouviere's sulcus. Hence, it can serve as an extrabiliary anatomical reference point during laparoscopic cholecystectomy to identify the location of CBD. MATERIALS AND METHODS: This prospective observational study was carried out on 99 patients during a period of 1 year. During laparoscopic cholecystectomy, Rouviere's sulcus was identified after retracting the fundus of the gallbladder toward the right shoulder. Its morphology in terms of open type, close type, or scar-like shapes was recorded, and if the CBD outline could be visualized, then its relation with the Rouviere's sulcus was noted. RESULTS: Among all 99 study patients, Rouviere's sulcus could be identified in 63 cases (63.63%), whereas it could not be seen in 36 cases (36.36%) (P < 0.007). It was of open type in 68.25% (43 cases), close type in 25.39% (16 cases), and scar like in 6.35% (4 cases) (P < 0.0001). The Rouviere's sulcus was found to be above the level of CBD line in 50 patients (79.36%) and at the same level in 11 patients (17.46%), and in two patients, (5.97%) CBD line could not be visualized. CONCLUSION: Identification of Rouviere's sulcus during laparoscopic cholecystectomy can serve as an additional reference point to avoid major bile duct injury. In the era of laparoscopy, it can be better visualized after creating the pneumoperitoneum and retracting the fundus of the gallbladder. Wolters Kluwer - Medknow 2020 2020-11-25 /pmc/articles/PMC8015955/ /pubmed/33243952 http://dx.doi.org/10.4103/aam.aam_4_20 Text en Copyright: © 2020 Annals of African Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Jha, Ashesh Kumar
Dewan, Rekha
Bhaduria, Kaustabh
Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title_full Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title_fullStr Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title_full_unstemmed Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title_short Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy
title_sort importance of rouviere's sulcus in laparoscopic cholecystectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015955/
https://www.ncbi.nlm.nih.gov/pubmed/33243952
http://dx.doi.org/10.4103/aam.aam_4_20
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