Long-term loss of Warren's shunt selectivity. Angiographic demonstration
J. Belghiti, P. Grenier, O. Nouel, H. Nahum and F. Fekete
Fifteen patients with a patent shunt after distal splenorenal shunt with
gastrosplenic disconnection were prospectively studied by angiography three
to 36 months after operation. In all patients a collateral circulation from
the portomesenteric to the gastrosplenic system was developed through
enlarged venous channels. In all patients the portal flow decreased, as
suggested by the angiographically assessed degradation of the portal
perfusion of the liver and/or the diminution of the diameter of the portal
vein. In two patients the portal vein was thrombotic. We conclude that
three months after operation distal splenorenal shunt with gastrosplenic
disconnection is not hemodynamically different than portacaval
laterolateral shunt.