Warren shunt. Clinical and angiographic results in 23 patients
Fekete, F.; Belghiti, J.; Grenier, P.; Nahum, H.; Rueff, B.
Gastroenterologie Clinique et Biologique 5(11): 1033-1038
1981
ISSN/ISBN: 0399-8320 PMID: 7308674 Document Number: 172606
Twenty-three patients with portal hypertension due to alcoholic cirrhosis were treated by distal splenorenal shunt and gastrosplenic mesenteric disconnection. In the postoperative period 2 patients died; in 1 patient gastrointestinal bleeding recurred 7 days after surgery and was due to ruptured varices with thrombosis of the splenorenal shunt; ascites developed in 14 patients. Twenty patients were followed up 6 mo. or more after surgery. Intestinal bleeding occurred in 3 patients with patent shunt. Ascites always disappeared within 3 mo. after operation. Four patients developed encephalopathy. Seventeen patients were investigated by angiography 3 mo. or more after surgery. The shunt was patent in 15 and occluded in 2 patients. In all patients with patent shunt a collateral circulation between the portomesenteric and the gastrosplenic systems developed. In all patients, the portal flow decreased as suggested by diminution of the diameter of the portal vein. Three mo. after operation, results of distal splenorenal shunt with gastrosplenic disconnection apparently are not hemodynamically different from those of side-to-side portocaval shunt.