Rouviere's sulcus - An anatomical landmark for safe laparoscopic cholecystectomy: A cross-sectional study

Basukala, Sunil; Thapa, Narayan; Tamang, Ayush; Shah, Kunda Bikram; Rayamajhi, Bikash Bahadur; Ayer, Dhirendra; Karki, Saurav; Basukala, Bikram; Sharma, Shriya; Dhakal, Sushil

doi:10.1016/j.amsu.2022.103404

Cited by 2 publications

(6 citation statements)

References 17 publications

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“…The sulcus is best seen when GB is flipped over toward the left side. It is absent in 10% of patients [19]. In a study conducted by Jha et al, Rouviere sulcus was found above the level of CBD in 79.36% patients [20].…”

Section: Rouviere Sulcusmentioning

confidence: 90%

“…In a study, Cheruiyut et al stated that Rouviere sulcus which has a constant anatomy can be used to delineate the lower limit of dissection in LC to prevent extra biliary and common duct injuries [21,22]. Another study by Basukala et al stated its use for preventing cystic artery injuries [19].…”

Section: Rouviere Sulcusmentioning

confidence: 99%

“…Dissection should be as close to gallbladder as possible. This technique has reduced the number of conversions of laparoscopic cholecystectomy to open and guides for subtotal cholecystectomy if difficult anatomy makes further dissection unsafe [19].…”

Section: Fundus First Dissectionmentioning

confidence: 99%

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Safety Landmarks in Laparoscopic Cholecystectomy

Bains,

Pradhan

2024

Gallstone Disease - Newer Insights and Current Trends

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Laparoscopic cholecystectomy stands as one of today’s most frequently performed medical procedures. The advent of laparoscopy and its widespread availability has instilled confidence in patients worldwide, leading them to embrace it as a preferred treatment. Given the procedure’s extensive adoption by surgeons across all skill levels—from novices to experts—it becomes imperative to establish a set of guidelines to ensure its safety for patients. With each patient exhibiting a distinct anatomical makeup and the complexity of surgeries ranging from straightforward cholecystectomies to intricate cases involving a frozen Calot’s triangle, it becomes paramount to approach gallbladder surgeries meticulously to avert any potential harm. Given its global prevalence, even a 0.1% complication rate translates to a significant figure. Therefore, practicing safe cholecystectomy is advocated strongly. This chapter provides the fundamental structure for performing a safe laparoscopic cholecystectomy. Encompassed within the chapter are insights into identifying critical landmarks for assessing the positioning of vital structures when confronted with compromised anatomical conditions.

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Section: Rouviere Sulcusmentioning

confidence: 90%

Section: Rouviere Sulcusmentioning

confidence: 99%

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Safety Landmarks in Laparoscopic Cholecystectomy

Bains,

Pradhan

2024

Gallstone Disease - Newer Insights and Current Trends

View full text Add to dashboard Cite

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“…Laparoscopic surgery presents challenges in anatomical identification since the structures are visualized in two dimensions. In recent years, significant efforts have been made to reduce the risk of iatrogenic biliary tract injuries and complications during laparoscopic cholecystectomy [ 1 ]. Nearly 0.5% of laparoscopic cholecystectomies result in bile duct damage.…”

Section: Introductionmentioning

confidence: 99%

“…In 1924, a French surgeon named M.H. Rouviere first reported the fissure that now bears his name [ 1 ]. A sulcus of 2-5 centimeters in length, Rouviere's sulcus may be seen to the right of the liver hilum, above the caudate lobe.…”

Section: Introductionmentioning

confidence: 99%

Rouviere’s Sulcus Analysis: A Critical Safety Analysis and a Guide to Safe Laparoscopic Cholecystectomy

Sharma¹,

Sood²,

Garg³

et al. 2023

Cureus

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Introduction: Laparoscopic cholecystectomy (LC) is the most frequent surgical operation in general surgery. The focus of recent research has been on improving the procedure's safety. Over 80% of healthy livers have Rouviere's sulcus (RVS), which is a natural notch in the right lobe that is present in proximity to the confluence of the bile duct. It is frequently considered an important component of safety during LC. RVS demarcates the area of the common bile duct (CBD) from the liver bed for the gall bladder. This research intends to evaluate the frequency, its relation to CBD, and the critical view of safety (CVS) during LC. Materials and Methods: An observational study was performed in a cohort of 50 patients listed for LC between September 2021 and September 2022. The presence of RVS was confirmed after liver retraction and dissection commenced. After the creation of CVS, its relationship with CBD was documented. Additionally, the position of the cystic lymph node was also documented during the dissection. Results: The findings of this study revealed that out of 50 patients, only 40 (80%) had RVS. However, cystic lymph nodes were present more frequently in 48 (96%) patients. CVS was achieved in all the patients, and it revealed the presence of RVS above the cystic duct-CBD junction in 37 (74%), at the level of the junction in 11 (22%), and in two (4%) where the junction could not be demarcated. Conclusion: RVS is a reliable marker to dissect laterally to CBD while doing LC, which does not require any dissection and can be appreciated early during the procedure. However, its presence along with the cystic lymph node gives a better anatomical understanding of the area of CBD, thereby assisting in conducting the procedure safely.

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Rouviere's sulcus - An anatomical landmark for safe laparoscopic cholecystectomy: A cross-sectional study

Cited by 2 publications

References 17 publications

Safety Landmarks in Laparoscopic Cholecystectomy

Safety Landmarks in Laparoscopic Cholecystectomy

Rouviere’s Sulcus Analysis: A Critical Safety Analysis and a Guide to Safe Laparoscopic Cholecystectomy

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