Practice of Deep Venous Thrombosis Prophylaxis and Its Incidence in Patients Undergoing Gastrointestinal and Hepatobiliary Surgery

Practice of Deep Venous Thrombosis Prophylaxis and Its Incidence in Patients Undergoing Gastrointestinal and Hepatobiliary Surgery: A Nepalese Single-center, Retrospective Study

Recent studies from Asia have reported a wide variation in the incidence of deep vein thrombosis (DVT), ranging from 5% to 50% in patients undergoing major abdominal surgery. However, data specific to the Nepalese population remains unavailable. This study aims to evaluate current thromboprophylaxis practices and determine the incidence of DVT in Nepalese adults undergoing gastrointestinal and hepatobiliary surgery.

Study Overview

• Status: Completed
• Conditions: Gastrointestinal
• Intervention / Treatment: Procedure: major gastrointestinal or hepatobiliary surgery under general anesthesia

• Study Type: Observational
• Enrollment (Actual): 1530

Contacts and Locations

Study Locations

• Nepal
  • Kathmandu, Nepal
    • Maharajgunj Medical Campus

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of adult patients aged >18 years who underwent major gastrointestinal or hepatobiliary surgery under general anesthesia at a tertiary referral center in Nepal. Patients were identified retrospectively through departmental audit records from the Department of Surgical Gastroenterology between October 2021 and April 2024. Major surgery was defined as any operative intervention involving the abdominal or hepatobiliary region requiring general anesthesia. Surgical procedures were categorized by organ system into upper gastrointestinal, hepatopancreatobiliary (HPB), colorectal, and other (e.g., small intestine, retroperitoneum, abdominal wall). Patients with a recent history of venous thromboembolism (VTE), known hypercoagulable conditions, atrial fibrillation, ongoing cancer therapy, pregnancy, or incomplete clinical data were excluded from the study. Data collected included demographic, clinical, intraoperative, and postoperative variables relevant to thromb

Description

Inclusion Criteria:

• Adults aged >18 years
• Underwent major gastrointestinal or hepatobiliary surgery
• Surgery performed under general anesthesia
• Major surgery defined as any operative intervention in the abdominal or hepatobiliary region requiring general anesthesia

Exclusion Criteria:

• History of VTE within 3 months before surgery
• Known hypercoagulable state or congenital thrombophilia
• Diagnosis of atrial fibrillation
• Undergoing systemic cancer chemotherapy or radiotherapy within the past 15 days
• Pregnant or lactating women
• Missing information in clinical records
• Non-operated patients or those receiving conservative management
• Patients undergoing liver transplantation

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients >18 years who underwent major gastrointestinal or hepatobiliary surgery	Procedure: major gastrointestinal or hepatobiliary surgery under general anesthesia; major gastrointestinal or hepatobiliary surgery under general anesthesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Use of Thromboprophylaxis and Incidence of DVT in Major GI and Hepatobiliary Surgeries	This outcome assesses the proportion of patients receiving appropriate thromboprophylaxis, as well as the incidence of deep vein thrombosis (DVT) among individuals undergoing major gastrointestinal and hepatobiliary surgeries. Data will be collected to evaluate adherence to prophylaxis guidelines and to determine the effectiveness of thromboprophylactic measures in preventing DVT in this surgical population.	From date of surgery until hospital discharge or up to 30 days postoperatively, whichever occurs first

Collaborators and Investigators

• Sponsor: Maharajgunj Medical Campus
• Investigators: Principal Investigator: Prajjwol Luitel, MBBS, Maharajgunj Medical Campus

Study record dates

Study Major Dates

• Study Start (Actual): May 23, 2024
• Primary Completion (Actual): July 21, 2024
• Study Completion (Actual): July 24, 2024

Study Registration Dates

• First Submitted: July 19, 2025
• First Submitted That Met QC Criteria: July 19, 2025
• First Posted (Actual): July 28, 2025

Study Record Updates

• Last Update Posted (Actual): July 28, 2025
• Last Update Submitted That Met QC Criteria: July 19, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Embolism and Thrombosis; Thrombosis; Venous Thrombosis; Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics
• Other Study ID Numbers: 589(6-11)E2.079/080

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) related to demographic characteristics, surgical details, thromboprophylaxis use, and DVT outcomes will be shared. This includes preoperative, intraoperative, and postoperative variables as collected in the study.
• IPD Sharing Time Frame: The IPD and supporting documents will be available beginning six months after publication of the study results and will remain available for up to five years thereafter.
• IPD Sharing Access Criteria: Access will be granted to qualified researchers and institutions conducting ethically approved research. Requests must include a brief study proposal and intended use. Data will be made available through a secure data-sharing platform upon signing a data use agreement.
• IPD Sharing Supporting Information Type: SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No