Role of Rouviere′s sulcus in relation to posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy

Abstract

Objective To evaluate the function of Rouviere′s sulcus with posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy. Methods The clinical data of 170 patients undergoing laparoscopic cholecystectomy through Rouviere′s sulcus approach with posterior cystohepatic triangle from May 2016 to June 2017 in the Department of General Surgery, the Second People′s Hospital of Wuhu were retrospectively analyzed. The incidences and types of Rouviere′s sulcus were documented. Results The open type of Rouviere′s sulcus was visualized in 108 patients(63.53%), the fused type in 44 patients(25.88%), and the deficient type in 18 patients (10.59%). Hence in a total of 152 (89.41%) patients had Rouviere′s sulcus. All patients underwent laparoscopic cholecystectomy safely. There was no bile duct injury or mortality. Four patients (2.35%) were converted to open operation, all were deficient type of Rouviere′s sulcus for chronic inflammation of the gallbladder triangle. Conclusion Rouviere′s sulcus are present and visible in most patients. Guided by Rouviere′s sulcus with posterior cystohepatic triangle it could be safely and effectively to expose the anatomical structure of Calot′s triangle and prevent bile duct injury in laparoscopic cholecystectomy. Key words: Cholecystectomy, laparoscopic; Intraoperative complications; Bile duct injury