Morphometry and Morphology of Rouviere’s Sulcus of Liver for Laparoscopic Cholecystectomy - A Cadaveric Study

Abstract

BACKGROUND The Rouviere’s sulcus (RS) is a horizontal sulcus on inferior surface of liver. The identification of RS may avoid bile duct injury during laparoscopic cholecystectomy and reduce the number of complications. RS is useful but often ignored anatomic landmark. The purpose of the study was to determine the presence/absence, types, and morphometry of demonstrable Rouviere’s sulcus. METHODS This observational study was conducted on 50 (cadaveric) liver specimens obtained during dissection. All the surfaces were meticulously observed, the RS was identified and photographed. The parameters like its presence/ absence, type of sulcus, length, breadth and depth were measured. Later it is classified into type 1, 2 & 3 depending on its morphology. RESULTS The Rouviere’s sulcus was present in 36 (72 %) specimens. The type 1RS in 29 (58 %), type 2 RS in 4 (8 %) and type 3 RS in 3 (6 %) specimens was observed. The RS was horizontal in 25 (50 %) specimens and oblique in 11 (22 %) specimens. The average length, breadth and depth of RS were 3.5 cm, 0.14 cm & 0.52 cm respectively. CONCLUSIONS The knowledge of presence / absence of Rouviere’s sulcus, its type and morphometry provide useful information to the surgeons to avoid bile duct injury during laparoscopic cholecystectomy and to achieve a good outcome. KEY Words Rouviere’s Sulcus, Laparoscopic Cholecystectomy, Bile Duct Injury

Rouvière’s Sulcus in a Jamaican Population

“…The literature search returned 49 publications that reported the prevalence of Rouvière's sulcus. After excluding 40 that reported on live patients undergoing surgery, there were nine publications reporting on Rouvière's sulcus in cadaveric specimens 1,8,11,12,13,14,15,16,17,18 . The mean prevalence of Rouvière's sulcus in cadaveric studies was calculated as 80.8% (Table 1).…”