Abstract: Objective To evaluate the efficacy of respiratory-guided ankle pump exercise combined with low molecular weight heparin (LMWH) in preventing DVT after radical resection of perihilar cholangiocarcinoma.Methods From January 2020 to December 2023, 114 patients who underwent radical resection of hilar cholangiocarcinoma were randomly divided into two groups by a random number table. There were 57 patients in the control group, who were treated with conventional intervention and LMWH. There were 57 cases in the observation group,which was combined breathing guided ankle pump exercise therapy was adopted on the basis of the control group.The hemorheological indicators, D-dimer levels, Caprini scores and the incidence of DVT were compared between the two groups at 1 week and 4 weeks after surgery. The incidence of complications of drug anticoagulation therapy such as bleeding at the surgical incision site, gastrointestinal bleeding and subcutaneous ecchymosis within 4 weeks after surgery was also statistically compared between the two groups.Results One week after surgery, the plasma viscosity, hemocytogene, fibrinogen and D-dimer of observation group and control group in turn were (1.25±0.06) mPa·s VS (1.38±0.08) mPa·s, (42.5±3.4)% VS (45.5±3.8)%, (3.0±0.4) g/L VS (3.3±0.5) g/L, and (0.50±0.16) mg/L VS (0.65±0.18) mg/L with statistically significant differences between the two groups (all P<0.05). Within four weeks after surgery, the DVT incidence of observation group and control group was 3.5% VS 14.0%, with statistically significant difference (P<0.05). Four week after surgery, the Caprini scores of observation group and control group was (7.96±2.20) points VS (9.07±1.81) points, with statistically significant difference (P<0.05). Within four weeks after surgery, there were no significant differences in these incidences of complication of drug anticoagulation therapy such as bleeding at the incision site, gastrointestinal bleeding and subcutaneous ecchymosis between the two groups (P>0.05）.Conclusion Combined intervention can effectively reduce the incidence of DVT and has good safety.

Key words: radical surgery for perihilar cholangiocarcinoma; lower limb deep vein thrombosis; respiratory-guided ankle pump exercises; low-molecular-weight heparin