Reviewer ’s report  
 
Title: Gallbladder polyps - a follow -up study after 11 years  
 
Version: 0 Date: 24 Aug 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer, 
please see the attached file.  
 
REVIEWER COMMENTS FROM REPORT: Brief summary of the findings presented in the 
manuscript  
 
The authors of the present study aimed to analyze the prevalence and long -term progression of 
gallbladder polyps in the general population. The results show that the prevalence of gallbladder 
polyps increased in the population.  Also, new lesions developed  in 8.7% of the tested group. 
Polyps continue to persist in 51.9% of the individuals.  
 
 
 
REQUESTED REVISIONS:  
Background  
The Background section is quite short, however, well -written and supported by the relevant 
references and clearly states the aim of th e study.  
 
Materials and Methods and Results  
The Materials and Methods section is well -described. The method of statistical analysis is 
appropriate.  
It would be beneficial for the paper to structure the Results section. This may include separating 
the text into small subsections with titles (for instance, one subsection describing the prevalence 
data and one subsection on the ultrasound scan characteristics.  
The authors provided a comprehensive analysis of the prevalence of gallbladder polyps in a 
populatio n sample. However, since the study aimed to investigate both the prevalence and long -
term progression, it would be interesting to know if any of the patients originally included in the 
study underwent cholecystectomy and if any histological analysis of the  polyps was performed.  
Also, since there several instrumental methods for the analysis of the polyps, has CT scanning 
ever been performed? CT scan is usually helpful in the analysis of tumorous polyps (Sun et al. 
Diagnosis and treatment of polypoid lesions  of the gallbladder: Report of 194 cases. 
Hepatobiliary Pancreat Dis. 2004).  
 
Discussion and Conclusion  
Although, as the Conclusion states the current study has been completed in 2013, there are 
several relevant papers, which were published after 2013 and may be included in the current 
manuscript as references.  
With regard to current guidelines and management of gallbladder polyps, the authors would be 
recommended to include the recently published joint guidelines from several European medical 
societies (Wi les et al. Management and follow -up of gallbladder polyps : Joint guidelines 
between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), 
European Association for Endoscopic Surgery and other Interventional Techniques (EAES), 
Internati onal Society of Digestive Surgery  - European Federation (EFISDS) and  European 
Society of Gastrointestinal Endoscopy (ESGE) (Eur Radiol 2017).  
In addition, a comprehensive paper reviewing a large number of publications focusing on 
progression of gallbladde r polyps has recently been published and may also be included as a 
reference (Babu et al. Management and diagnosis of gallbladder polyps: a systematic review. 
Langenbecks Arch Surg. 2015).  
Also, there are several other publications on the prevalence of ga llbladder polyps in general 
population, such as: Choi et al. Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a 
Healthy Population. Yonsei Med J. 2016.  
 
References  
Although the authors have provided an extensive list of relevant references, i t would be 
beneficial for the paper to include more recent publications mentioned above.  
Overall conclusion  
The current study follows the appropriate ethical and scientific standards. While completed in 
2013, the study is still relevant and provides valua ble data for the research on gallbladder polyps. 
The presented data will be interesting for both gastroenterologists and laboratory researchers. 
The manuscript would benefit from addition of several recent references relevant to this medical 
field. The man uscript may be published in a relevant gastroenterology or other relevant clinical 
journal with a moderate impact factor.  
 
 
The authors are recommended to add more recent references related to the studies of the 
prevalence and progression of gallbladder polyps.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
See comments above  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your commen ts to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salar y from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publicati on of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruite d by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attribut ed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Gallbladder polyps - a follow -up study after 11 years  
 
Version: 0 Date: 24 Aug 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer, 
please see the attached file.  
 
REVIEWER COMMENTS FROM REPORT: Brief summary of the findings presented in the 
manuscript  
 
The authors of the present study aimed to analyze the prevalence and long -term progression of 
gallbladder polyps in the general population. The results show that the prevalence of gallbladder 
polyps increased in the population.  Also, new lesions developed  in 8.7% of the tested group. 
Polyps continue to persist in 51.9% of the individuals.  
 
 
 
REQUESTED REVISIONS:  
Background  
The Background section is quite short, however, well -written and supported by the relevant 
references and clearly states the aim of th e study.  
 
Materials and Methods and Results  
The Materials and Methods section is well -described. The method of statistical analysis is 
appropriate.  
It would be beneficial for the paper to structure the Results section. This may include separating 
the text into small subsections with titles (for instance, one subsection describing the prevalence 
data and one subsection on the ultrasound scan characteristics.  
The authors provided a comprehensive analysis of the prevalence of gallbladder polyps in a 
populatio n sample. However, since the study aimed to investigate both the prevalence and long -
term progression, it would be interesting to know if any of the patients originally included in the 
study underwent cholecystectomy and if any histological analysis of the  polyps was performed.  
Also, since there several instrumental methods for the analysis of the polyps, has CT scanning 
ever been performed? CT scan is usually helpful in the analysis of tumorous polyps (Sun et al. 
Diagnosis and treatment of polypoid lesions  of the gallbladder: Report of 194 cases. 
Hepatobiliary Pancreat Dis. 2004).  
 
Discussion and Conclusion  
Although, as the Conclusion states the current study has been completed in 2013, there are 
several relevant papers, which were published after 2013 and may be included in the current 
manuscript as references.  
With regard to current guidelines and management of gallbladder polyps, the authors would be 
recommended to include the recently published joint guidelines from several European medical 
societies (Wi les et al. Management and follow -up of gallbladder polyps : Joint guidelines 
between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), 
European Association for Endoscopic Surgery and other Interventional Techniques (EAES), 
Internati onal Society of Digestive Surgery  - European Federation (EFISDS) and  European 
Society of Gastrointestinal Endoscopy (ESGE) (Eur Radiol 2017).  
In addition, a comprehensive paper reviewing a large number of publications focusing on 
progression of gallbladde r polyps has recently been published and may also be included as a 
reference (Babu et al. Management and diagnosis of gallbladder polyps: a systematic review. 
Langenbecks Arch Surg. 2015).  
Also, there are several other publications on the prevalence of ga llbladder polyps in general 
population, such as: Choi et al. Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a 
Healthy Population. Yonsei Med J. 2016.  
 
References  
Although the authors have provided an extensive list of relevant references, i t would be 
beneficial for the paper to include more recent publications mentioned above.  
Overall conclusion  
The current study follows the appropriate ethical and scientific standards. While completed in 
2013, the study is still relevant and provides valua ble data for the research on gallbladder polyps. 
The presented data will be interesting for both gastroenterologists and laboratory researchers. 
The manuscript would benefit from addition of several recent references relevant to this medical 
field. The man uscript may be published in a relevant gastroenterology or other relevant clinical 
journal with a moderate impact factor.  
 
 
The authors are recommended to add more recent references related to the studies of the 
prevalence and progression of gallbladder polyps.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
See comments above  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your commen ts to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salar y from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publicati on of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruite d by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attribut ed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Gallbladder polyps - a follow -up study after 11 years  
 
Version: 0 Date: 24 Aug 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer, 
please see the attached file.  
 
REVIEWER COMMENTS FROM REPORT: Brief summary of the findings presented in the 
manuscript  
 
The authors of the present study aimed to analyze the prevalence and long -term progression of 
gallbladder polyps in the general population. The results show that the prevalence of gallbladder 
polyps increased in the population.  Also, new lesions developed  in 8.7% of the tested group. 
Polyps continue to persist in 51.9% of the individuals.  
 
 
 
REQUESTED REVISIONS:  
Background  
The Background section is quite short, however, well -written and supported by the relevant 
references and clearly states the aim of th e study.  
 
Materials and Methods and Results  
The Materials and Methods section is well -described. The method of statistical analysis is 
appropriate.  
It would be beneficial for the paper to structure the Results section. This may include separating 
the text into small subsections with titles (for instance, one subsection describing the prevalence 
data and one subsection on the ultrasound scan characteristics.  
The authors provided a comprehensive analysis of the prevalence of gallbladder polyps in a 
populatio n sample. However, since the study aimed to investigate both the prevalence and long -
term progression, it would be interesting to know if any of the patients originally included in the 
study underwent cholecystectomy and if any histological analysis of the  polyps was performed.  
Also, since there several instrumental methods for the analysis of the polyps, has CT scanning 
ever been performed? CT scan is usually helpful in the analysis of tumorous polyps (Sun et al. 
Diagnosis and treatment of polypoid lesions  of the gallbladder: Report of 194 cases. 
Hepatobiliary Pancreat Dis. 2004).  
 
Discussion and Conclusion  
Although, as the Conclusion states the current study has been completed in 2013, there are 
several relevant papers, which were published after 2013 and may be included in the current 
manuscript as references.  
With regard to current guidelines and management of gallbladder polyps, the authors would be 
recommended to include the recently published joint guidelines from several European medical 
societies (Wi les et al. Management and follow -up of gallbladder polyps : Joint guidelines 
between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), 
European Association for Endoscopic Surgery and other Interventional Techniques (EAES), 
Internati onal Society of Digestive Surgery  - European Federation (EFISDS) and  European 
Society of Gastrointestinal Endoscopy (ESGE) (Eur Radiol 2017).  
In addition, a comprehensive paper reviewing a large number of publications focusing on 
progression of gallbladde r polyps has recently been published and may also be included as a 
reference (Babu et al. Management and diagnosis of gallbladder polyps: a systematic review. 
Langenbecks Arch Surg. 2015).  
Also, there are several other publications on the prevalence of ga llbladder polyps in general 
population, such as: Choi et al. Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a 
Healthy Population. Yonsei Med J. 2016.  
 
References  
Although the authors have provided an extensive list of relevant references, i t would be 
beneficial for the paper to include more recent publications mentioned above.  
Overall conclusion  
The current study follows the appropriate ethical and scientific standards. While completed in 
2013, the study is still relevant and provides valua ble data for the research on gallbladder polyps. 
The presented data will be interesting for both gastroenterologists and laboratory researchers. 
The manuscript would benefit from addition of several recent references relevant to this medical 
field. The man uscript may be published in a relevant gastroenterology or other relevant clinical 
journal with a moderate impact factor.  
 
 
The authors are recommended to add more recent references related to the studies of the 
prevalence and progression of gallbladder polyps.  
ADDITIONAL REQUESTS/SUGGESTIONS:  
See comments above  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your commen ts to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salar y from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publicati on of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruite d by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attribut ed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my  report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access C reative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant