{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:07:59Z","timestamp":1780301279633,"version":"3.54.0"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraoperative identification of Rouvi\u00e8re\u2019s sulcus is a proposed strategy to prevent bile duct injuries. Since it marks the plane at which the extra-hepatic ducts lie, limiting surgical dissection ventral to Rouvi\u00e8re\u2019s sulcus should protect the ducts from injury. This is an important adjunct when the critical view of safety cannot be achieved during difficult cholecystectomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational study of all consecutive elective laparoscopic cholecystectomies between January 1, 2017 and May 30, 2024. Intraoperatively, Rouvi\u00e8re\u2019s sulcus was identified by surgeons, with correlation by an independent observer. The relationship between the sulcus and the right hepatic pedicle was confirmed by laparoscopic ultrasound. Comparisons were made using SPSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over 7 years, 356 laparoscopic cholecystectomies were performed, and Rouvier\u00e9\u2019s sulcus could be identified in 296 (83.2%) patients. When a well-defined sulcus was present, it correlated reliably to the right portal triad in all cases. However, the reliability of this relationship significantly reduced in the absence of a well-defined sulcus (100% vs 5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When present, Rouvier\u00e9\u2019s sulcus is a valuable asset to surgeons, who can use it as a landmark for safe dissection planes during cholecystectomies. When a well-defined sulcus is absent, surgeons should employ alternative means of bile duct protection, such as indocyanine green or operative cholangiography.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261457629","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:55:03Z","timestamp":1780098903000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rouvi\u00e8re\u2019s Sulcus: An External Landmark for Safe Dissection when the Critical View Cannot Be Achieved"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3377-0303","authenticated-orcid":false,"given":"Shamir O.","family":"Cawich","sequence":"first","affiliation":[{"name":"School of Global Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil W.","family":"Pearce","sequence":"additional","affiliation":[{"name":"Southampton General Hospital NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kluger","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Dapri","sequence":"additional","affiliation":[{"name":"International School Reduced Scar Laparoscopy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Alseidi","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-440X","authenticated-orcid":false,"given":"Shaneeta","family":"Johnson","sequence":"additional","affiliation":[{"name":"School of Global Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solange CK","family":"Ramkissoon","sequence":"additional","affiliation":[{"name":"Eric Williams Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T","family":"Gardner","sequence":"additional","affiliation":[{"name":"University of the West Indies, Champ Fleurs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle K","family":"Cawich","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramnanand","family":"Shetty","sequence":"additional","affiliation":[{"name":"Eric Williams Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.4389"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zraa032"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-023-09928-5"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07852-6"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.517"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.18103\/mra.v10i8.2941"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/aam.aam_4_20"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23605"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v11.i2.62"},{"issue":"3","key":"e_1_3_4_11_2","first-page":"e104915","article-title":"Navigating the impossible gallbladder: bailout strategies and culture of safety in laparoscopic cholecystectomy","volume":"18","author":"Rauf F","year":"2026","unstructured":"Rauf F, Echevarria S, Aamir S, et al. Navigating the impossible gallbladder: bailout strategies and culture of safety in laparoscopic cholecystectomy. Cureus. 2026;18(3):e104915.","journal-title":"Cureus"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2024.03.057"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000000392"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348251328493"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261457629","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261457629","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261457629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T07:52:28Z","timestamp":1780300348000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261457629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":13,"alternative-id":["10.1177\/00031348261457629"],"URL":"https:\/\/doi.org\/10.1177\/00031348261457629","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"article-number":"00031348261457629"}}