Title: Rouviere’s Sulcus as a Safety Landmark in Laparoscopic Cholecystectomy
Authors: Dr Hitesh Bhatia, Dr Priya Bharati, Dr Samta, Dr Sandeep Bhatia
Background: Laparoscopic Cholecystectomy (LC) is the ―Gold Standard procedure for symptomatic gallstones nowadays. Knowledge of Surgical Anatomy is always important for a safe surgery. With the development of laparoscopic procedure, surgical interest in the Rouviere’s sulcus and its relation to the right portal pedicle has increased recently. This prospective study aimed at safety landmarks for avoiding Bile Duct Injuries during surgery and reducing the number of intraoperative and post operative complications in laparoscopic cholecystectomy.
Method: This prospective study was conducted on 50 patients who underwent laparoscopic cholecystectomy. During the standard procedure, Rouviere’s sulcus was identified and dissection of calot’s triangle was done above the level of sulcus and critical view of safety was created.
Results: Our majority of patients (76%) had well defined Rouviere’s Sulcus. In 22%, Sulcus was identified as ―just a faint line. And only a single patient presented with non identifiable Sulcus. There were only 2 intraoperative and 1 postoperative complication found in our study.
Conclusion: Rouviere’s Sulcus at the initial step in laparoscopy strengthens surgeon’s confidence and helps in reducing the operative time with safety so that we could reach to a zero Bile duct injury level in this surgery.
Keywords: Laparoscopic Cholecystectomy, Rouviere’s Sulcus, Bile Duct Injury.