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Morphology of the sulcus of the caudate process (Rouviere’s sulcus) in a Greek population and a systematic review with meta-analysis

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Abstract

The purpose of this study was to determine the prevalence and to investigate the morphology of the sulcus of the caudate process in a Greek population, along with a systematic review and meta-analysis of the literature. Overall, 103 consecutive patients undergoing laparoscopic cholecystectomy were included in the analysis. The sulcus was present in 91% and three morphological variants were identified (groove 69%, slit 21% and scar 10%). The sulcus had a horizontal course in 90% of patients and a mean length of 25 ± 13 mm. The meta-analysis included 27 surgical and 11 cadaveric studies with 6661 cases in total. The pooled prevalence of the sulcus was 80% and did not differ significantly among various geographical regions. Concerning sulcus subtypes, the binary “open/fused” classification was used to unify the heterogeneous data. The “open” type was more frequent than the “fused” (64.5% vs 35.5%). A horizontal course was observed in 53.5% and an oblique in 45.7%. The sulcus contained the right portal pedicle in 38%, the right posterior portal pedicle in 37%, and the right posteroinferior pedicle in 23.5%. In conclusion, the sulcus of the caudate process is a very helpful anatomical landmark in hepatectomy and laparoscopic cholecystectomy and can be identified in the majority of patients. However, various classifications for the morphological variants and diverse terminology cause discrepancy in the literature and create the need for a single classification system. The proposed 3-tier classification (groove, slit, scar) is simple and easy to remember and avoids ambiguous nomenclature.

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Authors and Affiliations

  1. Department of Surgery, Athens Naval and Veterans Hospital, Deinokratous 70, 11521, Athens, Greece

    Dimitrios K. Manatakis, Nikolaos Tasis, Maria Ioanna Antonopoulou & Christos Agalianos

  2. Department of Anatomy, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Maria Piagkou

  3. Laboratory of Anatomy, School of Medicine, University of Crete, Heraklion, Greece

    John Tsiaoussis

  4. Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Konstantinos Natsis

  5. Department of Surgical Oncology, St Savvas Cancer Hospital, Athens, Greece

    Dimitrios P. Korkolis

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  1. Dimitrios K. Manatakis
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  2. Nikolaos Tasis
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  3. Maria Ioanna Antonopoulou
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Correspondence to Dimitrios K. Manatakis.

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Manatakis, D.K., Tasis, N., Antonopoulou, M.I. et al. Morphology of the sulcus of the caudate process (Rouviere’s sulcus) in a Greek population and a systematic review with meta-analysis. Anat Sci Int 97, 90–99 (2022). https://doi.org/10.1007/s12565-021-00628-5

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  • DOI: https://doi.org/10.1007/s12565-021-00628-5

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