Investigating the Anatomy and Surgical Relevance of Rouviere's Sulcus

Rouviere's sulcus (RS) (i.e., incisura hepatis dextra, Gans incisura) represents an important
anatomical landmark. The study aimed to determine the frequency of the RS, its description, location,
relations to the right portal pedicle, the plane of the common bile duct, and the evaluation of the
surgical relevance of the obtained data. Forty macroscopically healthy and undamaged livers were
removed during autopsies from cadavers of both sexes. The RS was present in 82% of the cases,
and in these, the open RS was identified in 70% of the livers. The fused type was observed in 12% of
the cases; 18% of the livers had no sulcus. The mean length of the open type RS was 28 ± 2 mm
(range 24–32 mm), and its mean depth was 6 ± 2 mm (range 4–8 mm). The right posterior sectional
pedicle was found in the RS in 70% of the cases. In 5% of the livers, we also dissected a branch of
the anterior sectional pedicle. Inside 25% of the RS, we found the vein of segment 6. The RS
identification may avoid bile duct injury during laparoscopic cholecystectomy and enables elective
vascular control during the right liver resection.