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The sulcus of the caudate process (Rouviere’s sulcus): anatomy and clinical applications—a review of current literature

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Abstract

The sulcus of the caudate process is a horizontal groove on the inferior face of the liver. Its prevalence has not previously been determined. Because of its location, it represents a helpful extra-biliary landmark that could be used in biliary surgery to decrease bile duct injury. The goal of this study is to determine the prevalence of Rouviere’s sulcus and describe its anatomy and relevant surgical applications. We conducted a literature review on the various characteristics of the sulcus, selecting anatomical clinical studies and dissections. We performed 10 cadaveric dissections in the Laboratory of Anatomy at Purpan University to determine the contents. We selected 12 anatomical studies, conducted between 1924 and January 1st, 2020, which included 2394 patients. The prevalence of the sulcus is 78.24% ± 9.1. Classification of Singh was used to describe anatomical characteristics. Type I (“deep sulcus”) was identified in 50.4% ± 9.8 of cases, mostly consisting of Type Ia (open). Type II (“slit-like”) was estimated to account for 13.3% ± 13.2, whereas Type III (“scar”) described 12.3% ± 8.0. Average dimensions were estimated for length (26 mm ± 5.7), width (6.5 mm ± 1.5), and depth (7.9 mm ± 1.75). The content of the sulcus consists of the right portal vein and its division, the right hepatic artery, along with the right hepatic bile duct. The sulcus determines the orientation of the common bile duct. The sulcus of the caudate process is a reliable extra-biliary landmark, which presents a useful tool for reducing bile duct injuries during hepatobiliary surgery.

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Funding

This research was supported by the Laboratory of Anatomy of Purpan University, Toulouse, France.

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Authors and Affiliations

  1. Laboratory of Anatomy, University of Medicine Toulouse-Purpan, Toulouse III-Paul Sabatier, Toulouse, France

    G. Péré, V. Benvegnu, C. Mercé & R. Lopez

  2. Department of Digestive and Visceral Surgery, University Hospital of Toulouse-Rangueil, Rangueil, France

    G. Péré, C. Maulat & N. Carrère

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  1. G. Péré
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  2. V. Benvegnu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by PG, BV and MC. The first draft of the manuscript was written by PG and LR, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to G. Péré.

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Péré, G., Benvegnu, V., Mercé, C. et al. The sulcus of the caudate process (Rouviere’s sulcus): anatomy and clinical applications—a review of current literature. Surg Radiol Anat 42, 1441–1446 (2020). https://doi.org/10.1007/s00276-020-02529-0

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