During bilateral adrenalectomy, intraoperative dose of hydrocoisone should be given after
"Patients undergoing surgery for a primary adrenal adenoma secreting glucocoicoids require preoperative and postoperative steroids due to suppression of the contralateral adrenal gland. Duration of steroid therapy is determined by the ACTH stimulation test. Exogenous steroids may be needed for up to 2 years but are needed indefinitely in patients who have undergone bilateral adrenalectomy. This latter group of patients also may require mineralocoicoid replacement therapy." "Perioperative and postoperative glucocoicoid administration is obviously essential in the care of patients with Cushing's syndrome. For patients undergoing adrenalectomy for Cushing's syndrome, perioperative "stress dose" steroids (hydrocoisone, 100 mg IV every 8 hours for 24 hours) are recommended."
Opening the abdomen
Ligation of left adrenal vein
Ligation of right adrenal vein
Excision of both adrenal glands
Endocrinology and breast