Importance of Rouviere's Sulcus in Laparoscopic Cholecystectomy

Abstract

Background: For gallstones, laparoscopic cholecystectomy is the accepted standard technique.

Objectives: This work aimed to ascertain Rouviere's sulcus' frequency and significance as a marker in laparoscopic cholecystectomy procedures.

Patients and methods: 155 patients with symptomatic gallstone disease who had laparoscopic cholecystectomy at Menoufia University's  National Liver Institute were included in this prospective research.

Results: In 20 instances, adhesions were seen, and in 127  cases, the sulcus was apparent. In 109 instances, calot dissection was performed above the level of the Rouviere's sulcus; in 46 cases, it  was done at that level. Two cases suffered from biliary complications and another two suffered from blood loss. A total of 46 instances  (30%) had the dissection performed at the level of Rouviere's sulcus, and 3 cases (6.5%) had problems. Regarding postoperative data in  the study participants, collection was present in 5 cases, biliary leak in 2 cases. Postoperative wound infection occurred in 4 cases and  drain in 148 cases. Patients whose Rouviere's Sulcus (RS) was not visible had much longer hospital stays and surgery times than patients  whose RS was evident (p <0.001, =0.008, respectively).

Conclusion: Rouviere’s sulcus was present in (82%) of the total cases. It could be  concluded that a safe laparoscopic cholecystectomy requires a clear identification of this anatomical landmark.