Consideration of anatomy of the Rouviere’s sulcus in liver surgery in patients with metastatic colorectal cancer
Summary. Rouviere’s sulcus (RS) is an important anatomical landmark in liver surgery. Identification of RS can prevent damages of structures of gate of the liver during performing anatomical resections in the projection of the right lobe and provide selective vascular monitoring by a Glisson’s method, including selective Pringle maneuver in patients with metastatic colorectal cancer (mCRC). Aim. The aim of our study was to determine the variant anatomy of RS in patients with mCRC. Results. Of a 100 cases 82% had the RS: 70% had an open type of sulcus, whereas 12% had a fused type of sulcus, 18% hadn’t RS. The length of the open type of RS was 28±2 mm (range 24–32 mm) and the depth of the open type of the RS was 6±2 mm (range 4–8 mm). The right posterior sectional pedicle was found in 70% of cases and the branch of the portal vein was detected up to the VI segment in 25% of cases. Conclusions. Knowing of the variant anatomy of the RS makes operative interventions on the right lobe of the liver in mCRC patients safe.
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