Rouvière's sulcus: A useful landmark in laparoscopic cholecystectomy

Hugh, Thomas B.; Kelly, Michael D.; Mekisic, Allan

doi:10.1046/j.1365-2168.1997.02769.x

Cited by 63 publications

(76 citation statements)

References 3 publications

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“…Other methods described include various dissection techniques (infundibular, anterograde, etc. ), landmark techniques, Rouvière's sulcus [29], Calot's node [30], or use of ultrasound, just to name a few.…”

Section: Prevention Of Bile Duct Injuriesmentioning

confidence: 99%

Bile Duct Injury after Cholecystectomy: Surgical Therapy

Renz¹,

Bösch²,

Angele³

2017

Visc Med

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Background: Iatrogenic bile duct injuries (IBDI) after laparoscopic cholecystectomy (LC), being one of the most common performed surgical procedures, remain a substantial problem in gastrointestinal surgery. The most important aspect regarding this issue is the prevention of IBDI during index cholecystectomy. Once it occurs, early and accurate diagnosis of IBDI is very important for surgeons and gastroenterologists, because unidentified IBDI may result in severe complications such as hepatic failure and death. Laboratory tests, radiological imaging, and endoscopy play an important role in the diagnosis of biliary injuries. Methods: This review summarizes and discusses the current literature on the management of IBDI after LC from a surgical point of view. Results and Conclusion: In general, endoscopic techniques are recommended for the initial diagnosis and treatment of IBDI and are important to classify them correctly. In patients with complete dissection or obstruction of the bile duct, surgical management remains the only feasible option. Different surgical reconstructions are performed in patients with IBDI. According to the available literature, Roux-en-Y hepaticojejunostomy is the most frequent surgical reconstruction and is recommended by most authors. Long-term results are most important in the assessment of effectiveness of IBDI treatment. Apart from that, adequate diagnosis and treatment of IBDI may avoid many serious complications and improve the quality of life of our patients.

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Section: Prevention Of Bile Duct Injuriesmentioning

confidence: 99%

Bile Duct Injury after Cholecystectomy: Surgical Therapy

Renz¹,

Bösch²,

Angele³

2017

Visc Med

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“…Dissection may be started safely by division of the peritoneum immediately ventral to the sulcus. The importance of identifying RouviereÕs sulcus lies in the fact that the cystic duct and the cystic artery lie invariably anterosuperior to the sulcus, confirming the anatomy in the triangle of Calot [16]. The CBD is properly localized from time to time during surgery by retracting the duodenum downward, keeping in mind the plane of RouviereÕs sulcus and retracting the right lobe of the liver with proper traction to HartmannÕs pouch.…”

Section: Discussionmentioning

confidence: 95%

Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy

Singh

Ohri

2006

Surg Endosc

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The incidence of bile duct injury in laparoscopic cholecystectomy is 0.3% to 1.0%. This is higher than the incidence reported for open cholecystectomy (i.e., 0.1-0.2%), and the surgeons all over the world are relentlessly trying to find the ways and means to lower this incidence. Various operating strategies, techniques, and instrumentations such as the 0 degrees telescope, intraoperative cholangiogram, hydrodissection, and peanut gauze dissection have been claimed by various authors to minimize the risk of bile duct injury during cholecystectomy. However, the surgical fraternity agrees that there has been no substitute for meticulous dissection and display of various vital structures near the common bile duct. The authors describe seven anatomic landmarks encountered during laparoscopic cholecystectomy that assist in safe dissection to prevent bile duct and vascular injury. On the basis of their experience, they believe that if surgeons adhere to these landmarks, excellent results can be achieved.

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“…It contains the right portal triad or its branches. The sulcus identifies the plane of CBD accurately (a fact substantiated by cholangiographic studies) [2]. It can be identified in 80 % of cases.…”

Section: Rouviere's Sulcusmentioning

confidence: 97%

Innovative Approach to a Frozen Calot’s Triangle During Laparoscopic Cholecystectomy

Shinde

Pandit

2015

Indian J Surg

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The laparoscopic cholecystectomy is now the Bgold standard.^In around 2 % of cases, there is a need to convert because of the difficult dissection encountered in the Calot's Triangle, a Bfrozen Calot's triangle.^There is no consensus among surgeons about how to tackle this situation. To lower the conversion rate, there is a continuous attempt made to innovate. The authors present their rationale and experience in 100 difficult cases by creating a retro-gallbladder tunnel and encircling the gallbladder by a gauze for maneuvering.

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Rouvière's sulcus: A useful landmark in laparoscopic cholecystectomy

Cited by 63 publications

References 3 publications

Bile Duct Injury after Cholecystectomy: Surgical Therapy

Bile Duct Injury after Cholecystectomy: Surgical Therapy

Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy

Innovative Approach to a Frozen Calot’s Triangle During Laparoscopic Cholecystectomy

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