Rouviere’s sulcus as a safe landmark in laparoscopic cholecystectomy

Abstract EN

Objective : despite the advances in laparoscopic surgery, the risk of bile duct injury during laparoscopic cholecystectomy remains a substantial problem, even in the hand of experienced surgeons.

The aim of this study was to determine the frequency of demonstrable Rouviere’s sulcus, and to show that identification of this sulcus made safe surgery which may avoid injury of biliary ducts.

Methods : this is a prospective descriptive study design done in Azadi teaching and private Duhok hospitals from February 2013 till October 2016.

One hundred thirty patients who were posted for laparoscopic cholecystectomy were included, and divided into two groups : group A (85 patients) with Rouviere’s sulcus (classified as complete and incomplete or fused type), and Group B without sulcus (45 patients).

Results : a total of 130 patients who underwent laparoscopic cholecystectomy were included in the study.

Group A consist of 85 patients (65.3%) with Rouviere’s sulcus.

Open type of sulcus was visualized in 60 patients (46.1%), and the fused type was seen in 25 patients (19.2%) ; while Group B consists of 45 patients (34.6%).

The comparison between two groups was made in term of age, gender, duration of operation, and bile duct injury.

There was no statistical difference between two groups in term of age (p=0.14), gender (p=0.80), operative time (p=0.54) and no bile duct injury in both groups.

Conclusions: Rouviere’s sulcus is an easy reference point and fixed extrabiliary anatomical landmark, visualized in majority of patients.

Its identification before commencement of dissection can only be a component of the surgery, and may be helpful in preventing bile duct injury