Rouviere Sulcus Plane and Hepatic Hilum Plane, Which is Better as a Landmark in Laparoscopic Bile Duct Surgerys

Study Overview
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Brief Summary
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RS and the RS plane are important anatomical markers in laparoscopic cholecystectomy. However, there are many variations in the shape and orientation of the RS, and the RS plane is an imaginary plane, which can be misjudged by different surgeons. The purpose of this study is to introduce a more intuitive anatomical marker and anatomical plane, hilum plane, and discuss the application value of hilum plane in laparoscopic biliary surgery by comparing it with RS and RS plane.

Detailed Description
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Hepatic hilum plane is the hepatoduodenal serosa plane that extends from the base of the liver IVa segment down to the first segment of the gallbladder triangle. During the operation, first pulling the gallbladder to the head side, using the separating forceps to slide down horizontally from the hilum (the basement of hepatic segment Ⅳ), and along the serous of hepatoduodenal ligament, that is so called hilum plane. It forms a neck-shoulder structure when the hilar plane meets the tent-like hepatobiliary triangle. the serosa of hepatobiliary triangle was dissected on the neck area and ventral side of hilar plane, and the serosa of posterior triangle of the gallbladder was also cutted on the same extension line . In this process, the type and orientation of RS, the relationship between the plane of the RS sulcus and the plane of the hilar plane were also recorded and compared with hilum plane.

Official Title
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Rouviere Sulcus Plane and Hepatic Hilum Plane, Which is Better as a Landmark in Laparoscopic Bile Duct Surgerys

Conditions
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Cholelithiasis, Laparoscopic Cholecystectomy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Benign disease of the gallbladder requires surgery Exclusion Criteria: Patients with severe cirrhosis or had a history of partial hepatectomy were excluded from the statistics . patients with unexpected gallbladder carcinoma.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| The type and orientation of Rouviere sulcus<br>open type, fused type or absent type | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The type of Rouviere sulcus and the fake RS | The Rouviere sulcus was present if a fissure was seen in the liver parenchyma on the right side of the gallbladder and continues with the right posterior hepatic pedicle(fig ). RS were further subdivided into three classes: open type, fused type or absent type). The plane of RS sulcus was also recorded If the RS was not the absent type. | up to 30 days after surgery | 
| The orientation of RS and The relationship between hepatic portal plane and RS plane | the RS plane is an imaginary line drawn along the sulcus and carried across to the base of segment IV and form a security triangle. Similarly, the hilar plane can also form a triangle in posterior triangle of gallbladder. The areas of these triangles were Compared. | up to 30 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anatomy