Background: Laparoscopic cholecystectomy is the most commonly performed laparoscopic surgery worldwide. Laparoscopic cholecystectomy has an array of complications such as bile duct injuries and hemorrhages. Safe cholecystectomy is the priority to reduce the morbidity and mortality. There is a paradigm shift from extensive Calot’s dissection to identification of Rouviere’s sulcus and lesser dissection. Identification and analysis of Rouviere’s sulcus will help us doing a safe cholecystectomy and avoiding further injuries to bile ducts.
Methods: The study included 173 cases of laparoscopic
cholecystectomy, posted in elective OT and identified Rouviere’s sulcus during
laparoscopy. Table visual inspection and analysis was done. And the collected
data was analyzed for different types of sulcus, its position, morphology and
content. A simple statistical method was used in the study to find the mean
length as well.
Results: Of 173 cases, 160 cases had Rouviere’s sulcus. 13 cases
did not have a sulcus. Open type sulcus was present in 99 cases, 35 had closed
type, whereas 19 had slit type and only 7 had a scar like sulcus. The study
showed 92% of our patients had
Rouviere’s sulcus and of them 61.9% had an open type which was the most common
type of sulcus of them 18 cases had a visible pulsating vessel in the floor of
the sulcus i.e. posterior sectional pedicle in the sulcus.
Conclusions: Present study showed, in 92% cases it is easy and
approachable to visualise the Rouvier’s sulcus. It has different anatomical subtypes
and morphological variations in direction size and shape. So, it is feasible
and beneficial to identify the sulcus and keep the dissection above this level
to avoid common bile duct injury and further complication thereof.
Author
(s) Details
Bana Bihari Mishr
Department of General Surgery, SCB Medical College, Cuttack, Odisha, India.
Archana Kumari
Acharya
Department of General Surgery, SCB Medical College, Cuttack, Odisha, India.
Jyoti Ranjan Dash
Department of General Surgery, SCB Medical College, Cuttack, Odisha, India.
Debabrata Sahu
Department of General Surgery, SCB Medical College, Cuttack, Odisha, India.
Please see the book here:- https://doi.org/10.9734/bpi/acmms/v4/6921
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