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Morphological Analysis of Rouviere’s Sulcus in Laparoscopic Cholecystectomy: A Cross-sectional Study |
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Abhinash Singh, Mohit Sharma, Rana Ranjit Singh, Prabhjot Kaur Gill 1. Junior Resident, Department of Surgery, Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. 2. Professor, Department of Surgery, Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. 3. Professor and Head, Department of Surgery, Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. 4. Professor, Department of Genetics, Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. |
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Correspondence Address : Dr Mohit Sharma, Sri Guru Ram Das University of Health Sciences, Vallah, Mehta Road, Sri Amritsar, Amritsar, Punjab, India. E-mail: drmohit.gis@gmail.com |
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| ABSTRACT |  | ||||||
: Introduction: Laparoscopic Cholecystectomy (LC) is the gold standard for the management of gallbladder disease; however, the loss of tactile feedback increases the risk of Bile Duct Injury (BDI). Rouviere’s Sulcus (RS) serves as an important extrabiliary anatomical landmark that helps define a safe plane of dissection during surgery. Aim: To determine the prevalence, morphological variants, and morphometric dimensions of RS and to evaluate its association with demographic characteristics in patients undergoing elective LC. Materials and Methods: This hospital-based cross-sectional study was conducted from January 2024 to June 2025 in the Department of General Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. Hundred adult patients undergoing elective LC were included. Intraoperative visualisation and morphometric assessment of RS, including its length, width, and depth, were performed using a standardised four-port laparoscopic technique. The sulcus was classified into four morphological types (Types I-IV) based on established criteria. Due to small subgroup sizes for certain RS variants, Fisher’s exact test was used instead of Pearson’s Chi-square test when expected cell counts were fewer than 5. A p-value <0.05 was considered statistically significant. Results: The study population had a mean age of 48.24±13.73 years and comprised 78 females and 22 males (female-to-male ratio: 3.5:1). RS was identified in 80% of patients (95% CI: 71.2%-86.7%). Type I (Open type) was the predominant morphological variant, observed in 91.25% of visualised sulci, followed by Type III (5.0%), Type IV (2.5%), and Type II (1.25%). The mean length, width, and depth of Type I sulci were 21.00±10.02 mm, 2.56±1.95 mm, and 2.38±1.78 mm, respectively. No significant association was observed between RS morphology and patient age (p-value=0.626) or gender (p-value=0.848). Conclusion: The RS is a highly consistent and reliable anatomical landmark during LC, with its morphology remaining independent of demographic factors. | |||||||
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| Keywords : Anatomical landmark, Bile duct injury, Hepatobiliary surgery, Morphometry | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2026/89452.3114
Date of Submission: Apr 01, 2026 Date of Peer Review: Jun 11, 2026 Date of Acceptance: Jun 29, 2026 Date of Publishing: Jul 01, 2026 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval Obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. No PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Apr 03, 2026 • Manual Googling: Jun 22, 2026 • iThenticate Software: Jun 27, 2026 (1%) ETYMOLOGY: Author Origin EMENDATIONS: 6 |
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