[Warren's shunt in the treatment of portal hypertension in children].

Portal hypertension (PH) is often of extrahepatic origin in children. Several approaches have been proposed for its management: Observation, endosclerosis, devascularization and portosystemic shunting. Only the latter has an adequate haemodynamic rationale but the surgical risks, the fear of later portal deprivation encephalopathy and the difficulties of performing technically satisfactory anastomosis have discouraged many surgeons. Warren's distal spleno-renal shunt, selectively decompress esophageal varices and cures hypersplenism while sparing the spleen and providing a high flow anastomosis. We have used this operation in three patients with extrahepatic PH. All patients ceased bleeding and had their spleen size reduced with normal function.