To study the clinical significance of recanalized paraumbilical vein in hepatitis cirrhotic patients with portal hypertension.

Clinical data of 738 patients with hepatitis cirrhosis and portal hypertension from the Third Affiliated Hospital of Sun Yet-sen University were analyzed retrospectively. Local ethical committee approval had been received and that the informed concent of all participating subjects was obtained. Seven hundred and thirty-eight patients were divided into recanalized group and non-recanalized group according to recanalized paraumbilical vein detected by color Doppler ultrasound. The correlations between paraumbilical vein and the degree of esophageal and gastric varices, the incidence of hemorrhage, liver function and ascites were analyzed by the chi-square test and rank sum test.

There were 324 patients(43.9%) in the recanalized group while 414 patients(56.1%) in the non-recanalized group. There were 17 cases(10.4%) with moderate esophageal varices and 101 cases(61.6%) with severe esophageal varices in the recanalized group while 22 cases(10.2%) and 123 cases(56.9%) in the non-recanalized group respectively. There were 92 cases(56.1%) and 102 cases(47.2%) with gastric varices, 20 cases(6.2%) and 32 cases(7.7%) with variceal hemorrhage in the recanalized and non-recanalized group respectively. There was no significant difference between two groups in the degree of esophageal and gastric varices and the incidence of variceal hemorrhage (all in P>0.05) . For the liver function grading (Child-Pugh classification) of the recanalized group, 68(21%) patients were grade A, 178(54.9%) patients were grade B, and 78 (24.1%)patients were grade C. For the non-recanalized group, 193(46.6%) patients were grade A, 144(34.8%) patients were grade B, 77(18.6%) patients were grade C. The percentage of grade B and C patients in the recanalized group were markedly higher than that in the non-recanalized group. There was significant difference between two groups (P<0.01) . The incidence of ascites of the two groups were 59.2% and 34.6% respectively. There was significant difference between two groups (P<0.01) .

The recanalized rate of paraumbilical vein in hepatitis cirrhotic patients with portal hypertension is higher. The recanalized paraumbilical vein is not related to the incidence of esophageal and gastric varices and variceal hemorrhage. It is related to the incidence of ascites and the damage degree of liver function. The recanalized paraumbilical vein may indicate that ascites occurs more easily and severe liver function damage.