Search

Objective: Researchers described several anatomical landmarks, a method of identification of the cystic structures referred as “critical view of safety”, and operative techniques to avoid vascular and biliary injuries due to the laparoscopic cholecystectomy (LC). In this present study, we aimed to determine the frequencies, variations, and significance of Rouviere’s sulcus (RS) in the context of difficult laparoscopic cholecystectomy (DLC). Methods: The video records of 102 patients with gallbladder disease who underwent LC were reviewed. DLCs were determined according to Tokyo Guidelines. RS type and dimensions, if present, were noted. The features of RS were shown using descriptive statistics and collected data were analyzed using SPSS version 25.0. Results: Out of 102 patients RS was present in 80 (78.4%) patients. The most frequent type of the sulcus was horizontal, less frequently oblique, and rarely vertical. The most frequent sulcus type was type 1A, less frequently type 1B and type 2, and rarely type 3. The average dimension was 12.5 mm in length and 6.9 mm in width. A vessel or a biliary structure was commonly seen in type 1A sulci. We identified almost half of the cholecystectomy operations as DLCs and the RS was present in two-third of these DLCs while the RS was present in majority of standard LC. LC was performed in majority of the patients except for four patients in whom open surgery was preferred due to intense inflammation. No mortalities or bile duct injuries were identified. Conclusion: The frequency and type of RS in this sample from Turkey were found to be like the reports in literature. When available (present and visualized), RS contributes a lot to the safety measures of LC. When it comes to DLCs, the availability and convenience of RS might be limited or misleading for surgeons. [ABSTRACT FROM AUTHOR]