[Warren's anastomosis. Clinical and angiographic results (presentation of a series of 23 cases)].

Twenty-three patients with portal hypertension due to alcoholic cirrhosis were treated by distal splenorenal shunt and gastrosplenic mesenteric disconnection. In the post-operative period, two patients died; in one patient gastro-intestinal 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 months or more after surgery. Intestinal bleeding occurred in 3 patients with patent shunt. Ascites always disappeared within 3 months after operation. Four patients developed encephalopathy. Seventeen patients were investigated by angiography 3 months 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 to gastrosplenic systems developed. In all patients, the portal flow decreased as suggested by diminution of the diameter of the portal vein. The authors conclude that 3 months after operation, results of distal splenorenal shunt with gastrosplenic disconnection are not hemodynamically different from those of side-to-side portocaval shunt.