Rouvière's Sulcus as a Landmark for a Safe Laparoscopic Cholecystectomy: An Interim Analysis of a Multicenter Cross-sectional Study on the Prevalence and Morphologic Type of Rouvière's Sulcus in the Italian Population.

Autor:	Cirocchi R; Department of General Surgery, University of Perugia, Perugia., Properzi L; Department of General Surgery, University of Perugia, Perugia., Matteucci M; Department of General Surgery, University of Milan, Milan., Artico M; Department of General Surgery, Sapienza University of Rome, Rome., Vettoretto N; Department of General Surgery, Montichiari Surgery, ASST Spedali Civili Brescia, Brescia., Desiderio J; Azienda Ospedaliera S. Maria, Terni., Di Cintio A; Azienda Ospedaliera S. Maria, Terni., Di Nardo D; Azienda Ospedaliera S. Maria, Terni., Farinacci F; Azienda Ospedaliera S. Maria, Terni., Gemini A; Azienda Ospedaliera S. Maria, Terni., Guerci L; Azienda Ospedaliera S. Maria, Terni., Mazzetti S; Azienda Ospedaliera S. Maria, Terni., Ricci F; Azienda Ospedaliera S. Maria, Terni., Trastulli S; Azienda Ospedaliera S. Maria, Terni., Avenia S; Department of General Surgery, University of Perugia, Perugia., Boselli C; Department of General Surgery, University of Perugia, Perugia., Cirillo B; Department of General Surgery, Sapienza University of Rome, Rome., Brachini G; Department of General Surgery, Sapienza University of Rome, Rome., Fedeli P; Department of General Surgery, University of Camerino, Camerino., Montori G; Department of Surgery, Ulss2 Marca Trevigiana, Vittorio Veneto, Italy., Ursi P; Department of General Surgery, Sapienza University of Rome, Rome., Iandoli R; General Surgery P.O. Frangipane Ariano Irpino Asl AV, Ariano Irpino., Bergamini C; Careggi University Hospital, Florence., Giordano A; Department of Surgery, General Surgery Unit, S. Stefano Hospital, Azienda Asl Toscana Centro, Prato, Italy., Santoro A; Department of General Surgery, Sapienza University of Rome, Rome., Mingoli A; Department of General Surgery, Sapienza University of Rome, Rome., Antipas P; Azienda Ospedaliera S. Maria, Terni., Tebala GD; Azienda Ospedaliera S. Maria, Terni.
Jazyk:	angličtina
Zdroj:	Surgical laparoscopy, endoscopy & percutaneous techniques [Surg Laparosc Endosc Percutan Tech] 2024 Dec 06. Date of Electronic Publication: 2024 Dec 06.
DOI:	10.1097/SLE.0000000000001351
Abstrakt:	Background: Laparoscopic cholecystectomy is the gold standard in the treatment of symptomatic gallstones. The large number of gallbladders removed every year is not fully consistent with the excessively high incidence of iatrogenic bile duct injury (IBDI). Several strategies have been suggested to reduce this risk. Among them, the use of extra biliary anatomic structures, such as the Rouvière's sulcus, as a landmark to guide the surgeon during dissection has been proposed as a means to prevent IBDI. The main aim of the present paper is the evaluation of the prevalence of Rouvière's sulcus (RS) and its anatomic variants in a given population. Materials and Methods: This observational, cross-sectional, and multicenter study has been conducted at the Department of Digestive and Emergency Surgery of the "Azienda Ospedaliera Santa Maria," Terni (Italy), at the Department of Surgical Sciences of the "Azienda Ospedaliera Perugia," Perugia (Italy) and at the Department of Emergency and Trauma Surgery of the "Policlinico Umberto I," Rome (Italy). Intraoperative images of 111 patients undergoing laparoscopic cholecystectomy were analyzed to identify the presence and type of RS, according to the Singh-Prasad classification and the Dahmane classification. Results: RS was present in 93 (83.8%) patients. Singh-Prasad type 1A is present in 48.4% of patients, type 1B in 25.8%, type 2 in 12.9% and type 3 in 12.9%. Dahmane's open type is present in 48.4% of patients and fused type in 51.6%. Conclusion: Due to its high prevalence, RS can be used as an anatomic landmark and probably reduces the incidence of IBDI during laparoscopic cholecystectomy. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu