腹腔镜胆囊切除术中利用Rouviere沟协助定位胆囊管的临床应用

目的:探讨腹腔镜胆囊切除术中利用Rouviere沟(右肝管右后支进入肝脏的表面标志)协助定位胆囊管的优势。方法:收集2014年7月至2015年8月203例行LC患者的临床资料,其中实验组采用Rouviere沟协助定位胆囊管,传统组采用经Calot三角直接解剖胆囊管。对比两组手术时间、出血量、胆管损伤情况。结果:两组手术时间[(37.5±6.6)min vs.(42.7±11.3)min]、术中出血量[(39.6±11.1)ml vs.(58.4±28.2)ml]差异有统计学意义(P0.05)。传统组1例(0.99%)发生胆道损伤,1例(0.99%)腹腔内出血。结论:利用Rouviere沟协助定位胆囊管较传统方法在缩短手术时间、减少出血量方面具有优势。同时Rouviere沟的可见性较高,且利用其进行定位的方法较容易掌握,值得临床推广。

The clinical application of Rouviere sulcus in locating the cystic duct in laparoscopic cholecystectomy

Objective:To explore and summarize the advantages of using Rouviere sulcus ( the surface marker of the right pos-terior branch of the right hepatic duct into the liver) in locating the cystic duct during laparoscopic cholecystectomy. Methods:The clin-ical data of 203 patients who underwent laparoscopic cholecystectomy from Jul. 2014 to Aug. 2015 were collected, the experimental group used Rouviere sulcus to assist in locating the cystic duct,and in the traditional method group,the gallbladder duct was dissected via Calot triangle,the operative time,intraoperative blood loss and bile duct injury of two groups were compared. Results:The average operative time was (37. 5±6. 6) min and (42. 7±11. 3) min in the experimental group and the traditional method group,and the aver-age intraoperative blood loss was (39. 6±11. 1) ml and (58. 4±28. 2) ml,respectively. There were statistically significant differences in the operative time and intraoperative blood loss (P<0. 05). In addition,in the traditional method group,1 case of bile duct injury (0. 99％) and 1 case of intra-abdominal hemorrhage (0. 99％) occurred. Conclusions:The use of Rouviere sulcus in locating the cystic duct is superior to traditional methods in terms of reducing operative time and blood loss. At the same time,Rouviere sulcus is highly visible in the liver of Chinese people,this method of positioning is easy to be mastered,and is worthy of clinical promotion.