what is Rouviere's Sulcus ??? its significance in safe Lap Cholecystectomy.(Hindi) скачать в хорошем качестве

what is Rouviere's Sulcus ??? its significance in safe Lap Cholecystectomy.(Hindi)

Rouviere's sulcus is a 2-3cm cleft running to the right of the liver hilum anterior to segment 1 and is usually containing the right portal triad or its branches. The sulcus indicates the plane of common bile duct accurately. represents a cleft, anterior to the traditionally described "Segment I of the liver", which has more recently been described by Couinaud13 as Segment IX The most common advantage of identifying the sulcus is that the common bile duct lies below it, and the cystic duct and artery above it. Safe dissection zone. The R4U line is formed by Rouviere's sulcus (RS, four arrows) and runs from the base of liver segment IV to the hepatic ligament (R4U, red dotted line). This plane is the caudal border of the safe dissection zone. Above this plane is also the safe dissection triangle (7). Preparation above this plane ensures a safe distance to the main hepatic duct, its right branch, and first tion as well as the right hepatic artery. CD cystic duct, RHD right hepatic duct, PS Plane for save surgery The branches of the right posterior sectional pedicle were found in the RS in 70% of the cases. In 5% of the livers, we also dissected a branch of the anterior sectional pedicle. Inside 25% of the RS, we found the vein of segment 6 (Figures 3(a) and 3(b)). In 18%, we found the inconstant cystical vein.