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Anatomical Variations of Rouviere’s Sulcus in Egyptian Patients
            misleading of the vascular and biliary structures. With obscured RS     8.  Mogahed M, El-Atrebi K, Elwakeel B. Prevalence of gallstone
            or with frozen Calot triangle, meticulous dissection of vascular and   disease in Egyptian patients with hepatitis C virus infection. AAMJ
            biliary structures, adequate exposure of the cystic duct and artery,   2014;12(1):257–265.
            remain the cornerstone for safe LC. 19–21            9.  Bluth EI. Ultrasound: A Practical Approach to Clinical Problems, 2nd
                                                                    edition. New York: Thieme, 2008.
               In this study, RS was visualized in 92% of cases with healthy     10.  de’Angelis N, Catena F, Memeo R, et al. WSES guidelines for
            livers, while it was visualized in only 50% of cases with cirrhotic   the detection and management of bile duct injury during
            livers during LC. We believe that the current study is one of the   cholecystectomy. World J Emerg Surg 2021;16(1):30. DOI: 10.1186/
            first works discussing the RS in cirrhotic livers and we did not find   s13017-021-00369-w.
            studies discussing RS in cirrhotic livers to compare to our study.    11.  Pesce A, Palmucci S, La Greca G, et al. Iatrogenic bile duct injury: impact
                                                                    and management challenges. Clin Exp Gastroenterol 2019;12:121–
                                                                    128.  DOI: 10.2147/CEG.S169492.
            conclusIon                                           12.  Gans H. Study of anatomy of the intrahepatic structures and its
            Identification of RS provides an easy landmark for starting dissection   repercussions of hepatic surgery (Ph.D. thesis). Amsterdam, The
            of Calot’s triangle for safe LC as it facilitates the identification of   Netherlands: University of Nijmegen, Elsevier, 1955.
            the biliary and vascular structures and minimizes iatrogenic biliary     13.  Dahmane R, Morjane A, Starc A. Anatomy and surgical relevance of
            injuries. Identification of RS may not be easy in liver cirrhosis and   Rouviere’s sulcus. Sci World J 2013; 2013:254287. DOI: 10.1155/2013/
                                                                    254287.
            need careful dissection of vascular and biliary structures.    14.  Hugh TB, Kelly MD, Mekisic A. Rouviere’s sulcus: a useful landmark in
                                                                    laparoscopic cholecystectomy. Br J Surg 1997;84(9):1253–1254. DOI:
                                                                    10.1046/j.1365-2168.1997.02769.x.
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            206   World Journal of Laparoscopic Surgery, Volume 15 Issue 3 (September–December 2022)
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