The anatomy of Rouviere's sulcus as seen during laparoscopic cholecystectomy: A proposed classification

Singh, Mukhtiar; Prasad, Neeraj

doi:10.4103/0972-9941.201731

Cited by 22 publications

(11 citation statements)

References 5 publications

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“…It is believed that the hilar dissection may be safely initiated by division of the peritoneum immediately ventral to the RS sulcus [ 5 – 7 ]. Data from several studies indicated that the prevalence of RS was in the range 73–90.4% [ 10 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The open type of sulcus was defined as a cleft in which the sulcus was opening throughout its length. The fused type was defined as the sulcus with its proximal partial fusion [ 15 , 22 ]. A cadaveric study from Dahmane et al emphasized that the right hepatic pedicle or the branches of the right hepatic pedicle should be visible in the RS sulcus, no matter whether the RS was of the open type or the fused type [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…A cadaveric investigation found that the orientation of the RS roof is oblique to the anterior, inferior, and external edge of the liver (oblique) in 97% of the cadavers and horizontal in 3% of the cases [ 15 ]. But in laparoscopy, Singh and Prasad found that the direction of the sulcus in its various forms was mostly horizontal, sometimes oblique, and rarely vertical [ 22 ]. Kumar et al found that it was oblique in 59.1% of cases, and transverse (horizontal) in 40.9% of cases [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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The hilar plane compared with the Rouviere's sulcus plane during laparoscopic cholecystectomy.

Wang¹,

Hou²,

Zhou³

et al. 2022

Videosurgery and Other Miniinvasive Techniques

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Introduction: Rouviere's sulcus (RS) has been widely used as an important landmark during laparoscopic cholecystectomy; however, some shortcomings remain unaddressed. Aim: To evaluate the safety and application values of the hilar plane in laparoscopic cholecystectomy (LC) by comparing it with the plane of Rouviere's sulcus (RS plane). Material and methods: A retrospective study of 155 consecutive patients undergoing LC used the hilar plane as a guide for surgical procedures was performed. Intraoperative images were used to evaluate and analyze the value of using the hilar plane vs. the RS plane in preventing bile duct and vascular injuries. Meanwhile, anatomical data, including the types and orientations of Rouviere's sulci, were also recorded for further analysis. Results: Rouviere's sulci failed to be identified clearly in nine cases due to severe adhesions. The prevalence of RS was 83.6% (122/146). The hilar plane was a constant landmark. The hilar plane can also form a "security dissection triangle" in the posterior triangle of the gallbladder. The hilar plane and the RS plane formed a similar triangle in 59.8% (73/122) of cases, while in other cases, the hilar plane formed a smaller dissection triangle than the RS plane due to a higher spatial position. The hilar plane had a better protective effect for avoiding ectopic hepatic ducts or ectopic right hepatic arteries injury. Conclusions: The hilar plane has the features of constant location, large coverage area, and higher location, hence being further away from the critical structures. The hilar plane on its own can provide a safe anatomic plane in some case when RS was difficult to observe or identify.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The hilar plane compared with the Rouviere's sulcus plane during laparoscopic cholecystectomy.

Wang¹,

Hou²,

Zhou³

et al. 2022

Videosurgery and Other Miniinvasive Techniques

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“…Com a identificação do sulco de Rouviere, na maioria dos fígados saudáveis, podemos concluir que esse marco anatômico é um grande ponto de referência, já que 89,1% dos pacientes estudados apresentam-no, seja em forma de cicatriz ou em sulco real. Estudos anteriores mostram dados semelhantes em 2017, na qual a presença do sulco de Rouviere é de cerca de 82% dos pacientes 6 .…”

Section: Discussionunclassified

“…O sulco de Rouviere é um ponto anatômico comum que se faz presente em 82% dos fígados saudáveis, seja do tipo sulco real ou cicatriz. Sua identificação é importante, visto que pode ajudar a evitar lesões, dentre elas a lesão do ducto colédoco durante a colecistectomia laparoscópica, pois é um indicador do local apropriado para iniciar a dissecação do triângulo Calot 6 .…”

Section: Introductionunclassified

Sulco de Rouviere

Araujo

Neto

Filho

et al. 2022

J. Cienc. Saude HU-UFPI

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INTRODUÇÃO: Com o avanço da colecistectomia videolaparoscópica para tratamento de cálculos de vesícula biliar, foram desenvolvidas estratégias para a realização de cirurgias de forma segura, buscando reduzir complicações como: lesão de ducto biliar e sangramento. A identificação do sulco de Rouviere pode ajudar a evitar lesões, dentre elas a lesão do ducto colédoco durante a colecistectomia laparoscópica, pois é um indicador do local apropriado para iniciar a dissecação do triângulo Calot. OBJETIVOS: Avaliar a identificação do sulco de Rouviere em pacientes submetidos à colecistectomia laparoscópica, na unidade de cirurgia do Hospital Universitário da Universidade Federal do Piauí (HU-UFPI). METODOLOGIA: Análise descritiva através da observação das frequências absolutas (Nº) e relativas (%) e a prevalência do sulco de Rouviere, em um período de dois meses e meio. RESULTADOS: Foram analisados 92 pacientes, dos quais 82 apresentavam a presença do Sulco de Rouviere, que corresponde a 89,1% dos pacientes, e 10,9% dos pacientes não o apresentavam. Dos 82 pacientes que apresentaram a presença, 68 (82,9%) pacientes apresentaram na forma de sulco real, e 14 (17,1%) pacientes apresentaram na forma de cicatriz. 53 (64,6 %) pacientes apresentaram o Sulco de Rouviére na direção oblíqua, 26 (31,7%) na direção horizontal e apenas 3 (3,7%) na vertical. CONCLUSÃO: O estudo mostrou que o sulco de Rouviere é um marco comum anatômico presente em 89,1% da nossa amostra e que na sua grande maioria é na forma de sulco real ou fosseta, 82,9%. A direção do Sulco de Rouviere no nosso estudo mostrou que a grande maioria se apresenta na direção obliqua e horizontal, 64,6% e 31,7% respectivamente, ficando a direção vertical com 3,7% da amostra.

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The prevalence of the Rouviere's sulcus: A meta‐analysis with implications for laparoscopic cholecystectomy

et al. 2020

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Rouvière's sulcus (RS) is increasingly being recognized as an important extra‐biliary landmark during laparoscopic cholecystectomy (LC). The aim of this study was to conduct a systematic analysis of the prevalence and morphological types of RS. A systematic search was conducted through the major databases PubMed, ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), SciELO, and the Cochrane Library to identify studies eligible for inclusion. The data were extracted and pooled into a random‐effects meta‐analysis using STATA software. The primary and secondary outcomes of the study were the pooled prevalence of RS and its morphological types, respectively. A total of 23 studies (n = 4,495 patients) were included. The overall pooled prevalence of RS was 83% (95% confidence interval [CI] [78, 87]). There were no significant differences in prevalence between cadaveric studies (82%, 95% CI [76, 87]) and laparoscopic studies (83%, 95% CI [77, 88]). The open RS constituted 66% (95% CI [61, 71]) of all cases, while the closed type was present in 34% (95% CI [29, 39]). RS is a relatively constant anatomical structure that can be reliably identified in most patients undergoing cholecystectomy. It can therefore be used as a fixed extra‐biliary landmark for the appropriate site at which to start dissecting during LC to help prevent iatrogenic bile duct injury.

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The anatomy of Rouviere's sulcus as seen during laparoscopic cholecystectomy: A proposed classification

Cited by 22 publications

References 5 publications

The hilar plane compared with the Rouviere's sulcus plane during laparoscopic cholecystectomy.

The hilar plane compared with the Rouviere's sulcus plane during laparoscopic cholecystectomy.

Sulco de Rouviere

The prevalence of the Rouviere's sulcus: A meta‐analysis with implications for laparoscopic cholecystectomy

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