Journal of Surgery Concepts & Practice >

2022 , Vol. 27 >Issue 03: 239 - 243

DOI: https://doi.org/10.16139/j.1007-9610.2022.03.011

Original article

Rouviere′s sulcus guided retro-gallbladder tunnel dissection in difficult laparoscopic cholecystectomy

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  • 1. Department of Hepatobiliary Surgery, Tengzhou Central People′s Hospital, Shandong Tengzhou 277500, China
    2. Biliary Tract Surgery Ⅰ, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai 200433, China

Received date: 2021-10-19

  Online published: 2022-08-03

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Abstract

Objective To explore Rouviere′s sulcus guided retro-gallbladder tunnel dissection cholecystectomy used in difficult laparoscopic cholecystectomy. Methods A retrospective analysis of 1 081 patients with laparoscopic cholecystectomy in Tengzhou Central People′s Hospital from January 2019 to October 2020 was done. A total of 125 cases had scores ≥6 indicating difficult laparoscopic cholecystectomy based on preoperative scoring system to predict difficult laparoscopic cholecystectomy by Gupta. There were 65 cases(study group) with laparoscopic cholecystectomy using Rouviere′s sulcus guided retro-gallbladder tunnel dissection and 60 cases(control group) with routine laparoscopic cholecystectomy. Clinical data with operation and postoperative complication were compared between two groups. Results Operative time of two groups was [(61±23) min vs. (88±24) min], operative blood loss [(46±16) mL vs. (62±23) mL, hospital length of stay [(3.5±1.5) d vs. (5.8±2.2) d] and hospital cost [(12 236±316) yuan vs. (14 199±552) yuan] with statistical significant difference (P<0.05). Visual analog scale at 12 h and 24 h after operation in study group were (2.7±1.1) and (3.0±1.1), less than those in control group (5.9±1.0) and (6.4±1.5) significantly(P<0.05). One case with conversion of laparotomy was present in study group and 6 cases in control group (P<0.05). There was no case with bile leakage in study group and 4 cases in control group (P<0.05). Liver function was more improved significantly 72 hours postoperative in study group than in control group (P<0.05). There was no bile duct injury in study group and 1 bile duct injury in control group (P>0.05). Conclusions Rouviere′s sulcus guided retro-gallbladder tunnel dissection in difficult cholecystectomy could be safe laparoscopic cholecystectomy.

Key words： Laparoscopic cholecystectomy; Difficult gallbladder; Rouviere′s sulcus; Retro-gallbladder tunnel

Cite this article

MAN Gaoya, DANG Tongke, WU Qingsong, FENG Feiling . Rouviere′s sulcus guided retro-gallbladder tunnel dissection in difficult laparoscopic cholecystectomy[J]. Journal of Surgery Concepts & Practice, 2022 , 27(03) : 239 -243 . DOI: 10.16139/j.1007-9610.2022.03.011

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