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目的:探讨腹腔镜肾上腺手术时肾上腺血管的解剖变异与处理方法。方法:对经腹腔前入路作腹腔镜肾上腺或腺瘤切除术中,游离肾上腺发现7例肾上腺血管解剖变异并予妥善处理。结果:右侧肾上腺血管解剖变异为:中央静脉与右下肝静脉汇合后汇入下腔静脉;中央静脉汇入右肾静脉与下腔静脉的交汇处;多支中央静脉。左侧肾上腺血管解剖变异为:中央静脉与膈下静脉分别汇入左肾静脉;中央静脉与左副肾静脉汇合为主干后汇入左肾静脉。均予仔细分离血管、钛夹夹闭后切断,无一例发生意外。结论:了解并能在术中辨别肾上腺的血管解剖变异,有助于安全地进行腹腔镜肾上腺手术。
Objective: To investigate the anatomic variation and treatment of adrenal vessels during laparoscopic adrenalectomy. Methods: For laparoscopic adrenalectomy or adenoma resection via transperitoneal approach, seven cases of adrenal vascular anatomical variation were found in the free adrenal gland and were properly treated. Results: The anatomical variation of the right adrenal artery was that the central vein merged with the right lower hepatic vein into the inferior vena cava, the central vein merged into the junction of the right renal vein and inferior vena cava, and multiple central veins. The anatomical variation of the left adrenal blood vessels is: the central vein and the phrenic vein are respectively introduced into the left renal vein; the central vein merges with the left accessory renal vein into the trunk and then into the left renal vein. All blood vessels were carefully separated, and the titanium clips were cut off after clipping. No accident occurred. CONCLUSIONS: Understanding and identifying intra-arterial anatomical variations in the adrenal gland facilitates safe laparoscopic adrenalectomy.