European Journal of Anatomy

Official Journal of The Spanish Society of Anatomy
Cover Volume 22 - Number 5
Eur J Anat, 22 (5): 389-395 (2018)

Anatomical parameters of the Rouviere’s sulcus for laparoscopic cholecystectomy

Lelika Lazarus1, JS Luckrajh1, S. Mewa Kinoo2, Bhugwan Singh2

1Department of Clinical Anatomy, School of Laboratory Medicine and Medical Science College of Health Sciences, University of KwaZulu-Natal Westville Campus, Private Bag X54001 Durban 4000, 2Department of Surgery School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, PO Box 17039, Congella 4013

ABSTRACT Rouviere’s sulcus (RS) is a structure on the posterior surface of the liver that appears as a transverse cleft extending from the caudate process to the right lobe. RS lies exactly in the plane of the common bile duct, giving it important clinical applications in laparoscopic cholecystectomy, partial hepatectomy and other hepatobiliary operations. This study aimed to describe the morphology of RS, as well as to provide measurements of the length, breadth and width of the sulcus.The present study included the analysis of 75 formalin-fixed adult livers. RS was present in 82.67% of cases in the right lobe of the livers. The morphology of the sulcus was classified into three Types viz. Type 1 describes a deep sulcus in the right lobe. This was further subdivided into Type 1A (44%), which describes the RS as a deep sulcus which was continuous medially within the hilum of the liver; Type 1B (6.67%) describes RS as a deep sulcus which was fused medially. Type 2 (25.33%) was slit-like, superficial and narrow. Type 3 describes RS as a scar, since it appeared as a fused line. RS has an average length of 3.16 cm, an average breadth of 0.1 cm and an average depth of 0.78 cm.Since the advent of laparoscopic cholecystectomy, the incidence of bile duct injuries has steadily increased. RS has been identified as an extra-biliary landmark that may mitigate iatrogenic injuries resulting from such hepatobiliary surgeries. Therefore, a thorough understanding of the anatomy of RS is of significant importance to surgeons and hepatologists.

Keywords: Rouviere’s sulcus – Liver anatomy – Laparoscopic cholecystectomy – Morphology – Morphometry – Clinical anatomy

European Journal of anatomy
ISSN 2340-311X (Online)