Rouvière’s sulcus variants from a clinical perspective: A systematic review

Table 2 Publications documenting the prevalence and types of Rouvière’s sulcus

Ref.	Population	Study description	Prevalence	Open	Closed	Absent	Undefined	Slit	Scar
Rouvière et al[1], 1924	France	Observational study of 45 fetal and newborn cadavers	37/45 (82.2%)	ND	ND	8/45 (17.8%)	ND	ND	ND
Rouvière et al[1], 1924	France	Observational study of 40 adult cadavers	21/40 (52.5%)	ND	ND	19/40 (47.5%)	ND	ND	ND
Gans et al[2], 1955	Netherlands	Observational study in 115 cadaveric liver corrosion casts	92/115 (80%)	ND	ND	23/115 (20%)	ND	ND	ND
Couinaud et al[5], 1957	France	Observational study of 116 cadaveric liver corrosion casts	85/116 (73.3%)	ND	ND	31/116 (26.7%)	ND	ND	ND
Reynaud et al[3], 1991	France	Observational study of 100 cadaveric dissections	73/100 (73%)	NR	NR	27/100 (27%)	ND	ND	ND
Hugh et al[12], 1997	Australia	Observation of 100 patients for laparoscopic cholecystectomy	78/100 (78%)	41/100 (41%)	37/100 (37%)	22/100 (22%)	ND	ND	ND
Zubair et al[13], 2009	Pakistan	Prospective study of 160 patients at laparoscopic cholecystectomy	109/160 (68.1%)	48/109 (44%)	61/109 (56%)	51/160 (31.9%)	ND	ND	ND
Cai et al[14], 2012	China	Observation of 584 patients at laparoscopic cholecystectomy	448/584 (76.7%)	346/584 (59.3%)	102/584 (17.5%)	136/584 (23.3%)	ND	ND	ND
Dahmane et al[15], 2013	Solvenia	Prospective study of 40 cadaveric liver corrosion casts	33/40 (82.5%)	28/40 (70%)	5/40 (12.5%)	7/40 (17.5%)	ND	ND	ND
Wang et al[16], 2014	China	Prospective study of laparoscopic cholecystectomy in 750 patients	705/750 (94%)	ND	ND	45/750 (6%)	ND	ND	ND
Thapa et al[17], 2015	Nepal	Prospective study of 200 patients at laparoscopic cholecystectomy	150/200 (75%)	81/150 (54%)	18/150 (12%)	50/200 (25%)	ND	ND	ND
Kim et al[18], 2016	Republic of Korea	Prospective study of 369 patients at laparoscopic cholecystectomy	277/369 (75.1%)	229/369 (62.1%)	48/369 (13%)	62/369 (16.8%)1	30/369 (8.1%)1	ND	ND
Arora et al[19], 2016	India	Observations in 100 patients at laparoscopic cholecystectomy	90/100 (90%)	59/100 (59%)	NR	10/100 (10%)	ND	24/100 (24%)	7/100 (7%)
Cîmpeanu et al[4], 2017	Romania	Observation of 300 patients at open/Laparoscopic cholecystectomy	186/300 (62%)	130/300 (43.3%)	56/300 (18.7%)	114/300 (38%)	ND	ND	ND
Singh et al[20], 2017	Punjab, India	Retrospective study of 117 videos of laparoscopic cholecystectomy	106/117 (90.6%)	60/106 (56.6%)	11/106 (10.4%)	11/117 (9.4%)	6/106 (5.7%)	23/106 (21.7%)	6/106 (5.7%)
Zhao et al[10], 2017	China	Prospective study of 75 patients at laparoscopic cholecystectomy	56/60 (93.3%)	34/60 (56.7%)	16/60 (26.7%)	4/60 (6.7%)	ND	ND	6/10 (10.0%)
Al-Nasser et al[21], 2018	Bhagdad, Iraq	Prospective study of 402 patients at laparoscopic cholecystectomy	319/402 (79.4%)	221/402 (54.9%)	98/402 (24.4%)	83/402 (20.7%)	0	ND	ND
Lattoo et al[23], 2018	Asia	Prospective study of 382 patients at laparoscopic cholecystectomy	242/382 (63.4%)	152/242 (62.8%)	26/242 (10.7%)	140/382 (36.6%)	0	58/242 (23.96%)	6/242 (2.48%)
Lazarus et al[24], 2018	South Africa	An analysis of 75 formalin-fixed adult cadavers	62/75 (82.7%)	33/75 (44%)	5/75 (6.7%)	13/75 (17.3%)	0	19/75 (25.3%)	5/75 (6.7%)
Almas et al[25], 2018	Pakistan	Prospective study of 160 patients at laparoscopic cholecystectomy	109/160 (68.1%)	48/109 (44%)	61/109 (56%)	51/160 (31.9%)	0	ND	ND
Dubhashi et al[26], 2018	India	Prospective study of 50 patients at laparoscopic cholecystectomy	49/50 (98%)	42/50 (84%)	8/50 (16%)	1/50 (2%)	0	ND	ND
Rafi et al[27], 2018	Pakistan	Prospective study of 131 patients at laparoscopic cholecystectomy	98/131 (74.8%)	57/131 (43.5%)	41/131 (31.3%)	33/131 (25.2%)	0	ND	ND
Chen et al[28], 2018	China	Prospective study of 170 patients at laparoscopic cholecystectomy	152/170 (89.4%)	108/170 (63.5%)	44/170 (25.9%)	18/170 (10.6%)	0	ND	ND
Bhatia et al[30], 2019	Punjab, India	Prospective study of 50 patients at laparoscopic cholecystectomy	49/50 (98%)	NR	NR	1/50 (2%)		NR	11/50 (22%)
Schendel et al[29], 2019	Canada	Prospective study of 127 patients at laparoscopic cholecystectomy	101/127 (79.5%)	NR	NR	26/127 (20.5%)	NR	NR	NR
Garg et al[31], 2019	Uttar Pradesh, India	Retrospective study of 90 Cadaveric livers	71/90 (78.9%)	41/90 (45%)	6/90 (7.2%)	19/90 (21.1%)		21/90 (23.33%)	3/90 (3.33%)
Jha et al[32], 2020	Delhi, India	Prospective study of 99 patients at laparoscopic cholecystectomy	63/99 (63.6%)	43/99 (43.4%)	16/99 (16.2%)	36/99 (36.4%)	ND	ND	4/99 (4%)
Elwan et al[33], 2020	Egypt	Prospective study of 300 patients at laparoscopic cholecystectomy	293/300 (97.7%)	175/300 (58.3%)	118/300 (39.3%)	7/300 (2.3%)	ND	ND	ND
Kumar et al[34], 2020	Nepal	Prospective study of 230 patients at laparoscopic cholecystectomy	208/230 (90.4%)	114/208 (54.8%)	26/208 (12.5%)	22/230 (9.6%)	ND	22/208 (10.6%)	46/208 (22.1%)
Mishra et al[35], 2020	Odisha, India	Prospective study of 160 patients at laparoscopic choleycstectomy	147/160 (91.9%)	99/160 (61.9%)	35/160 (21.9%)	13/160 (8.1%)	0	19/160 (11.9%)	7/160 (4.4%)
Péré et al[36], 2020	France	Prospective study of 10 cadaveric dissections	8/10 (80%)	3/10 (30%)	2/10 (20%)	2/10 (20%)		1/10 (10%)	2/10 (20%)
Abdelfattah et al[37], 2021	Egypt	Retrospective study of 100 videos of laparoscopic cholecystectomies	86/100 (86%)	53/100 (53%)	16/100 (16%)	14/100 (14%)		11/100 (11%)	6/100 (6%)
Bajpayee et al[38], 2021	Maharashtra, India	Retrospective study of 45 embalmed cadaveric livers	40/45 (88.9%)	22/45 (48.9%)	4/45 (8.9%)	5/45 (11.1%)	0	12/45 (26.7%)	2/45 (4.4%)
Cheruiyot et al[39], 2021	Global	Systematic review of major databases of 4495 patients across 23 studies	3731/4495 (83%)	2967/4495 (66%)	1528/4495 (34%)	764/4495 (17%)	ND	ND	ND
Nyaanga et al[40], 2021	Kenya	Observational study of 116 formalin-fixed cadaveric livers	98/116 (84.5%)	77/116 (66.4%)	11/116 (9.5%)	18/116 (15.5%)	ND	ND	10/116 (8.3%)
Deshatty et al[41], 2021	India	Retrospective study of 50 cadaveric livers	36/50 (72%)	24/50 (48%)	5/50 (10%)	14/50 (28%)	0	4/50 (8%)	3/50 (6%)
Cawich et al[42], 2022	Trinidad	Prospective study of 50 cadaveric livers	43/50 (86%)	27/50 (54%)	14/50 (28%)	7/50 (14%)	0	ND	2/50 (4%)
Basukala et al[43], 2022	Nepal	Observation of 180 patients at laparoscopic cholecystectomy	169/180 (93.9%)	114/169 (67.4%)	26/169 (15.3%)	11/180 (6.1%)		22/169 (13%)	7/169 (4.1%)
Acet et al[44], 2022	Turkey	Retrospective study of 102 videos of laparoscopic cholecystectomy	80/102 (78.4%)	51/102 (50%)	14/102 (13.7%)	22/102 (21.6%)	0	7/102 (6.9%)	8/102 (7.8%)
Manatakis et al[46], 2022	Greece	Prospective study of 103 patients at laparoscopic cholecystectomy	94/103 (91.3%)	65/103 (63.1%)	20/103 (19.4%)	9/103 (8.7%)	ND	ND	9/103 (8.3%)
Manatakis et al[46], 2022	Global	Metanalysis of 6661 persons across 27 operative and 11 cadaveric studies (4433 cases compared for morphology)	5309/6661 (79.7%)	2859/4433 (64.5%)	1574/4433 (35.5%)2	1352/6661 (20.3%)	ND	ND
Wang et al[47], 2022	Hefei, China	Retrospective study of 146 patients at laparoscopic cholecystectomy	122/146 (83.6%)	105/146 (71.9%)	17/146 (11.6%)	24/146 (16.4%)3	ND
Ragavan et al[48], 2022	Puducherry, India	Observational study of 93 cadaveric livers	61/93 (65.6%)	37/93 (39.8%)	9/93 (9.7%)	32/93 (34.4%)	ND	10/93 (10.8%)	5/93 (5.4%)
El-Saman et al[49], 2022	Egypt	100 laparoscopic cholecystectomies	76/100 (76%)	43/100 (43%)	13/100 (13%)	24/100 (24%)	ND	11/100 (11%)	9/100 (9%)
Gardner et al[50], 2022	Jamaica	Prospective study of 60 cadaveric livers	49/60 (81.7%)	40/60 (66.6%)	7/60 (11.7%)	11/60 (18.3%)	0	0	2/60 (3.3%)
Bhattarai et al[45], 2022	Nepal	A prospective study of 100 patients undergoing laparoscopic cholecystectomy	79/100 (79%)	52/100 (52%)	17/100 (17%)	21/100 (21%)	0	7/100 (7%)	3/100 (3%)
Sreevidya et al[51], 2023	Tamilnadu, India	Retrospective observational study of 52 cadaveric livers	47/52 (90.4%)	26/52 (50%)	4/52 (7.7%)	5/52 (9.6%)	0	8/52 (15.4%)	9/52 (17.3%)
Voruganti et al[52], 2023	Andhra Pradesh, India	Prospective study of 130 patients undergoing laparoscopic cholecystectomy	106/130 (81.5%)	77/106 (72.6%)	14/106 (13.2%)	24/130 (18.5%)	0	11/106 (10.4%)	4/106 (3.8%)
Sharma et al[54], 2023	Solan, India	Observational study in 50 persons undergoing laparoscopic cholecystectomy	40/50 (80%)	26/50 (52%)	14/50 (28%)	10/50 (20%)	0	0	0
Ibrarullah et al[54], 2023	Odisha, India	Prospective study of 500 patients undergoing laparoscopic cholecystectomy4	306/423 (72.34%)	194/423 (45.86%)	57/423 (13.48%)	117/423 (27.66%)	12/423 (2.84%)5	1/423 (0.24%)	42/423 (9.93%)
Cirocchi et al[55], 2024	Italy	Prospective studies of 123 patients undergoing laparoscopic surgery	105/123 (85.3%)	54/123 (43.9%)	27/123 (22%)	18/123 (14.6%)	ND	12/123 (9.76%)	12/123 (9.76%)
Cirocchi et al[55], 2024	Italy	Metanalysis of 1802 persons across 14 studies investigating the presence of Rouverie’s Sulcus	1488/1802 (82.6%)	1083/1802 (60.1%)	256/1802 (14.2%)	314/1802 (17.4%)	ND	312/1802 (17.3%)	153/1802 (8.5%)
Hamad et al[56], 2024	Pakistan	Prospective study of 93 patients undergoing laparoscopic cholecystectomy	50/93 (53.8%)	ND	ND	43/93 (46.2%)	ND	ND	ND
Ismaeil et al[57], 2024	Kurdistan, Iraq	Prospective study of 419 patients undergoing laparoscopic cholecystectomy	320/419 (76.4%)	ND	ND	99/419 (23.6%)	ND	ND	ND
Kanhaiya et al[58], 2024	New Delhi, India	Prospective analysis of 302 patients undergoing laparoscopic cholecystectomy	229/302 (75.8%)	123/302 (40.7%)6	30/302 (9.9%)7	73/302 (24.1%)		53/302 (17.6%)8	23/302 (7.6%)
Smithmaitrie et al[59], 2024	Thailand	Retrospective analysis of 3320 videos of patients undergoing laparoscopic cholecystectomy	1702/3320 (51.3%)	1166/3320 (35.1%)	9	1618/3320 (48.7%)	ND	9	273/3320 (8.2%)
Risekesan et al[60], 2025	Trichy, India	Prospective study of 63 patients at laparoscopic cholecystectomy	44/63 (69.8%)	31/63 (49.2%)	13/63 (20.6%)	19/63 (30.2%)	0	0	0
Parsa et al[61], 2025		Prospective study of 192 patients at laparoscopic cholecystectomy	168/192 (87.5%)	126/168 (75%)	37/168 (22%)	24/192 (12.5%)	0	2/168 (1.2%)	3/168 (1.8%)
Cirocchi et al[62], 2025	Italy	Prospective study of 111 patients at laparoscopic cholecystectomy	93/111 (83.8%)	45/93 (48.4%)	24/93 (25.8%)	18/111 (16.2%)	0	12/93 (12.9%)	12/93 (12.9%)
Cho et al[63], 2025	Seoul, Korea	Prospective study of 83 patients at laparoscopic/robotic hepatectomy	83/83 (100%)	62/83 (74.7%)	21/83 (25.3%)	0/83	0	0	0
Global prevalence	Global		19371/25196 (76.88%)	11741/20711 (56.69%)	3039/12858 (23.64%)	5709/24681 (23.13%)	12/423 (2.84%)	682/4819 (14.15%)	700/8627 (8.11%)
This study	Caribbean		296/356 (83.2%)	140/356 (39.33%)	69/356 (19.38%)	60/356 (16.9%)	0	65/356 (18.26%)	22/356 (6.18%)
2-tailed P value			0.005306	< 0.0001	0.061988	0.005230		0.033397	0.188331
Standard error			0.0225	0.0265	0.0228	0.0225		0.0193	0.0147
Z-score			-2.7878	6.5506	1.8664	2.7925		-2.1273	1.3155

¹Absent and “non-determined” grouped together.

²Excluded because the classification is unclear. It appears that the author has grouped scar and closed types together in this study.

³Excluded because classification is unclear. It appears that the author has grouped absent, slit and scar types together.

⁴77 could not be evaluated due to adhesions.

⁵Type 1c: A sulcus that was fused centrally and open medially and laterally.

⁶Reclassified based on images and descriptions published by the authors. Original classification described these as open (66) + groove (47) types.

⁷Reclassified based on images and descriptions published by the authors. Original classification described these as pit (19) + fused (11) types.

⁸Reclassified based on images and descriptions published by the authors. Original classification described these as closed (33) + slit (20) types.

⁹Excluded because the classification is unclear. It appears that the author has grouped closed and slit types together.

ND: Not defined; NR: Not reported.