A team of researchers from China developed a nomogram to assess the risk of venous thromboembolism in patients undergoing surgery for distal cholangiocarcinoma. They published their research in the Asian Journal of Surgery

The rate of venous thromboembolism is high among patients undergoing distal cholangiocarcinoma surgery and is associated with adverse outcomes. 

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The new nomogram could help clinicians screen out patients at high risk and take preventive measures accordingly, the study authors noted.

To assess the rate of venous thromboembolism in patients undergoing distal cholangiocarcinoma surgery, the team led by Ren Lang, of the Capital Medical University, in Beijing, China, conducted a single-center study in 177 patients.

Of these 177 patients, 64 (36%) developed venous thromboembolism following the operation. 

The researchers identified age, surgical procedure, tumor, nodes, and metastases (TNM) stage, duration of the ventilator, and D-dimer before the operation as independent risk factors.

They constructed their nomogram based on these factors in order to predict the risk of venous thromboembolism following first-time distal cholangiocarcinoma surgery. 

The areas under the receiver operating curve of the nomogram were 0.80 in the training group and 0.79 in the validation group. 

Patients who developed venous thromboembolism had a worse prognosis.

Cholangiocarcinoma is a heterogeneous group of malignant tumors affecting the liver. Based on the anatomical origin of the tumor, the disease can be classified as intrahepatic or extrahepatic cholangiocarcinoma. Extrahepatic cholangiocarcinoma is further divided into 2, as perihilar and distal cholangiocarcinoma.

Venous thromboembolism is the formation of a blood clot in a vein. It includes deep vein thrombosis, which occurs when a blood clot forms in a deep vein, and pulmonary embolism, which when a blood clot travels to the lungs through the bloodstream.


Chen Q, Cui S, Huang J, et al. Venous thromboembolism in patients undergoing distal cholangiocarcinoma surgery: prevalence, risk factors, and outcome. Asian J Surg. Published online February 14, 2023. doi:10.1016/j.asjsur.2023.02.015