Abstract: Objective To investigate the incidence and clinical implications of venous thromboembolism in patients diagnosed with advanced cholangiocarcinoma. Methods From March 2019 to March 2020, Sixty-five patients with clinicopathologically confirmed advanced cholangiocarcinoma were admitted to our hospital. These patients were categorized into two groups based on the occurrence of venous thromboembolism: and occurrence group (n=35) and a non-occurrence group (n=30). Post-admission, all patients underwent laboratory testing, routine blood examinations, lower limb deep vein ultrasound, and Caprini scale assessments, A univariate analysis of indicators from both groups was conducted, followed by a multicariate logistic regression analysis of variables that exhibited statistically significant differences in the univariate analysis. This approach aimed to identify risk factors associated with the development of venous thromboembolism in patients with cholangiocarcinoma. Results The univariate analysis revealed that the occurence group demonstrated significantly higher levels of platelet, D-dimer and fibrinogen, with values of (419.4 ± 102.5) × 10⁹/L, (2.9 ± 1.3) mg/L, and (9.8 ± 2.6) mg/L, respectively, compared to the non-occurrence group, which showed levels of (302.1 ± 25.6) × 10⁹/L, (1.8 ± 1.2) mg/L, (7.5 ± 1.8 ) mg/L. Furthermore, the antithrombin III level in the occurrence group was significantly lower at (72.9±8.5)%, compared to (98.2±25.8)% in the non-occurrence group (P<0.05). The multifactorial logistic regression analysis identified platelets, D-dimer, fibrinogen, antithrombin III, caprini assessment results, and findings from lower extremity deep vein ultrasound as independent risk factors for venous thromboembolism in patients with cholangiocarcinoma, with odds ratios(OR) of 4.577, 4.702, 5.018, 4.797, 5.114, 4.674, and 5.038, respectively(P<0.05). Conclusion Patients with advanced cholangiocarcinoma are identified as having a high incidence of venous thromboembolism. In such patients, factors including platelet count, antithrombin III levels, D-dimer, fibrinogen, Caprini scale ratings, and ultrasound examinations have been found to predict the occurrence of venous thromboembolism to a significant extent. These parameters not only aid in anticipating venous thromboembolism but also serve as crucial clinical tools for confirming its presence in patients with advanced cholangiocarcinoma. Consequently, the results from these tests are instrumental in the clinical diagnosis of venous thromboembolism in this patient population.

Key words: Progressive stage, Cholangiocarcinoma, Venous thromboembolism, Incidence, Clinical implications