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After distal splenorenal anastomosis, as described by Warren, in 23 patients, early assessment of results (after 2 weeks and 2 months) by endoscopic examination and celiomesenteric angiography was used to evaluate the effectiveness of the procedure and its effects on hepatic portal perfusion. The distal splenorenal shunt remained open in almost all cases (22 out of 23), the varices diminished, and postoperative hemorrhage rarely occurred (3/23 cases). The portogastric disconnection was incomplete in 8 patients, preservation of hepatoportal flow not being constant, as 6 cases with partial and 2 cases with complete portal thrombosis were observed.

The results are reported of 40 distal spleno-renal shunts as described by Warren, carried out from 1975 to 1980. Angiographically, the shunt appeared functional in 37 cases and thrombosed in 3; flow towards the liver was preserved in 28 of the operated patients, but in 12 cases there was portal thrombosis, partial (10 cases) or total (2 cases). Five of the operated cases (12.5%) died soon afterwards, 3 of these from recurrent haemorrhage associated twice with thrombosis of the shunt and once with a massive portal thrombosis. Two patients died subsequently at 4 months ans 3 1/2 years from liver failure. The 33 other patients, at a follow-up of 1 to 6 years, are leading a normal life without encephalopathy or recurrent haemorrhage.