Abstract
Methods This is a prospective observational study involving patients of age ≥16 years who underwent laparoscopic cholecystectomy for uncomplicated gall stone at BPKIHS between May and July 2019. Result 230 cases were analyzed, and RS was present in 90.4%. Open sulcus type was the commonest (54%), followed by scar type (22.9%), closed sulcus type (12.5%), and slit type (10.6%), respectively. In 59.1% of cases, it was oblique to the anterior, inferior, and external edge of the liver, while in the remaining cases, it was transverse. The mean ± SD values for operative time and duration of hospital stay in the RS visible and the RS not visible groups were 29.16 ± 8.736 and 42.9 ± 23.646 minutes, and 1.26 ± 0.440 and 1.90 ± 0.910 days, respectively (p value ≤0.001). One minor complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 minor complications occurred in the RS not visible group. Only one major complication occurred in the RS not visible group. Conclusion Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy.
Highlights
Introduction eRouviere’s sulcus (RS) represents a cleft, anterior to the traditionally described “segment 1 of liver” which has been recently described by Couinaud as segment IX [1]
One minor complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 minor complications occurred in the RS not visible group
Aim We aim to find the distribution of anatomical characteristics of RS seen during laparoscopic cholecystectomy in the population of our part of the world and its association with bile duct injury and other comorbidities
Summary
Introduction eRouviere’s sulcus (RS) represents a cleft, anterior to the traditionally described “segment 1 of liver” which has been recently described by Couinaud as segment IX [1]. Whatever is previously known about the sulcus came to us from some seminal studies on liver anatomy by Reynaud, Gans, and Couinaud who just noted that this sulcus was present in the majority [1,2,3]. Is study was undertaken to describe the detail anatomy of RS in the population of our part of the world and to discuss the critical aspects of incorporating this useful landmark in safe cholecystectomy. We believe that this study may increase awareness regarding variations in anatomy of Rouviere’s sulcus and guide surgeons to perform safe laparoscopic cholecystectomy. E aim of this study was to find the distribution of anatomical characteristics of RS seen during laparoscopic cholecystectomy in the population of our part of the world and its association with complications. Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy
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