Reviewer’s report
Title: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 1 Date: 11 Dec 2018
Reviewer: Armand Abergel
Reviewer's report:
Thank you for the responses to the different comments
Some points should be improved:
Page 3, lane 9 : the most frequent hepatic, biliary and pancreatic finding were respectively fatty liver,  
cholelithiasis and acute pancreatitis.
lane 9 : It is difficult to clearly know how the percentages are calculated. I think it could be useful to  
add every time the numerator, the denominator and the percentage. Example : 55% (120/220). 
You have to tell maybe in the methods that the calculation method tend to surestimate the frequency of  
the events.
lane 12 :  For example in the abstract 5.3% of them had positive hepatitis B. Add in parenthesis :  
12/225. I am not sure that the precision 5.3% is necessary. 5% is enough (12/225)
lane 15 : 24 patients had drug related side effects. The 2 cases with hyperamylasemia, are not side  
effects. The 2 patients with SULFASALAZINE cannot be imputed to sulfasalazine after 1.5 to 5 years.  
Then we are left with 21 patients with DILI and 3 with DIPI.
Page 3, lane 17: it is very difficult to diagnose exacerbation of hepatitis C as ALT fluctuates in CHC.  
Plase replace by one case of chronic hepatitis 
lane 19. replace some kind by an 
Page 3, lane 21: replace innocent by benign
Page 4, lane 21: replace not a rare by common
Page 4, lane 25, remove cumulative 
Page 5, lane 8: I will add autoimmune pancreatitis in the differential diagnosis
Page 5, lane 20: only 30% have typical histology. I will remove typical.
Page 6, lane 19: revealed abnormal findings
lane 26 : remove in patients
remove information on sulfasalazine unless you have good arguments for keeping it
Page 7, lane 2: patient with primary
Page 7, lane 5. The most common pancreatic manifestation. What was the etiology for the fourth  
patient ?
Page 7, lane 28. four patients with ALT > 3 ULN and not one.
Page 9, lane 5: of our study
lane 14 : with a highest number of males having cholelithiasis
lane 17 : concerning PSC
lane 19 : our retrospective
Page 10, lane 7: mesalazine
lane 7: The delay between drug introduction and acute pancreatitis was similar....
lane 9: should include DIPI, biliary pancreatitis, auto-immune pancreatitis and duodenal involvment.
lane 12 : of their immunisation for hepatitis 
lane 21 : the low proportion
Page 11, lanes 18 to 20 : it is a result and should be included in the results section
lane 21 : ULN
lane 22 : may be better tolerated
Page 12, lane 1: In our study, one out of four....
-A descriptive Table is necessary and can replace the Table 2
Colums : Whole population, UC, Crohn
Lanes : age sex, severity, localisation, frequency of the extra-intestinal manifestations.....
-Table 3 : I think sulfasalazine should be removed unless you have very good reasons to think that it is  
responsible of DILI
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 comments to the authors.
Unable to assess
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 quality 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 salary 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 publication 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.
No conflict of interest
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 Creative 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: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 1 Date: 11 Dec 2018
Reviewer: Armand Abergel
Reviewer's report:
Thank you for the responses to the different comments
Some points should be improved:
Page 3, lane 9 : the most frequent hepatic, biliary and pancreatic finding were respectively fatty liver,  
cholelithiasis and acute pancreatitis.
lane 9 : It is difficult to clearly know how the percentages are calculated. I think it could be useful to  
add every time the numerator, the denominator and the percentage. Example : 55% (120/220). 
You have to tell maybe in the methods that the calculation method tend to surestimate the frequency of  
the events.
lane 12 :  For example in the abstract 5.3% of them had positive hepatitis B. Add in parenthesis :  
12/225. I am not sure that the precision 5.3% is necessary. 5% is enough (12/225)
lane 15 : 24 patients had drug related side effects. The 2 cases with hyperamylasemia, are not side  
effects. The 2 patients with SULFASALAZINE cannot be imputed to sulfasalazine after 1.5 to 5 years.  
Then we are left with 21 patients with DILI and 3 with DIPI.
Page 3, lane 17: it is very difficult to diagnose exacerbation of hepatitis C as ALT fluctuates in CHC.  
Plase replace by one case of chronic hepatitis 
lane 19. replace some kind by an 
Page 3, lane 21: replace innocent by benign
Page 4, lane 21: replace not a rare by common
Page 4, lane 25, remove cumulative 
Page 5, lane 8: I will add autoimmune pancreatitis in the differential diagnosis
Page 5, lane 20: only 30% have typical histology. I will remove typical.
Page 6, lane 19: revealed abnormal findings
lane 26 : remove in patients
remove information on sulfasalazine unless you have good arguments for keeping it
Page 7, lane 2: patient with primary
Page 7, lane 5. The most common pancreatic manifestation. What was the etiology for the fourth  
patient ?
Page 7, lane 28. four patients with ALT > 3 ULN and not one.
Page 9, lane 5: of our study
lane 14 : with a highest number of males having cholelithiasis
lane 17 : concerning PSC
lane 19 : our retrospective
Page 10, lane 7: mesalazine
lane 7: The delay between drug introduction and acute pancreatitis was similar....
lane 9: should include DIPI, biliary pancreatitis, auto-immune pancreatitis and duodenal involvment.
lane 12 : of their immunisation for hepatitis 
lane 21 : the low proportion
Page 11, lanes 18 to 20 : it is a result and should be included in the results section
lane 21 : ULN
lane 22 : may be better tolerated
Page 12, lane 1: In our study, one out of four....
-A descriptive Table is necessary and can replace the Table 2
Colums : Whole population, UC, Crohn
Lanes : age sex, severity, localisation, frequency of the extra-intestinal manifestations.....
-Table 3 : I think sulfasalazine should be removed unless you have very good reasons to think that it is  
responsible of DILI
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 comments to the authors.
Unable to assess
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 quality 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 salary 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 publication 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.
No conflict of interest
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 Creative 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: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 1 Date: 11 Dec 2018
Reviewer: Armand Abergel
Reviewer's report:
Thank you for the responses to the different comments
Some points should be improved:
Page 3, lane 9 : the most frequent hepatic, biliary and pancreatic finding were respectively fatty liver,  
cholelithiasis and acute pancreatitis.
lane 9 : It is difficult to clearly know how the percentages are calculated. I think it could be useful to  
add every time the numerator, the denominator and the percentage. Example : 55% (120/220). 
You have to tell maybe in the methods that the calculation method tend to surestimate the frequency of  
the events.
lane 12 :  For example in the abstract 5.3% of them had positive hepatitis B. Add in parenthesis :  
12/225. I am not sure that the precision 5.3% is necessary. 5% is enough (12/225)
lane 15 : 24 patients had drug related side effects. The 2 cases with hyperamylasemia, are not side  
effects. The 2 patients with SULFASALAZINE cannot be imputed to sulfasalazine after 1.5 to 5 years.  
Then we are left with 21 patients with DILI and 3 with DIPI.
Page 3, lane 17: it is very difficult to diagnose exacerbation of hepatitis C as ALT fluctuates in CHC.  
Plase replace by one case of chronic hepatitis 
lane 19. replace some kind by an 
Page 3, lane 21: replace innocent by benign
Page 4, lane 21: replace not a rare by common
Page 4, lane 25, remove cumulative 
Page 5, lane 8: I will add autoimmune pancreatitis in the differential diagnosis
Page 5, lane 20: only 30% have typical histology. I will remove typical.
Page 6, lane 19: revealed abnormal findings
lane 26 : remove in patients
remove information on sulfasalazine unless you have good arguments for keeping it
Page 7, lane 2: patient with primary
Page 7, lane 5. The most common pancreatic manifestation. What was the etiology for the fourth  
patient ?
Page 7, lane 28. four patients with ALT > 3 ULN and not one.
Page 9, lane 5: of our study
lane 14 : with a highest number of males having cholelithiasis
lane 17 : concerning PSC
lane 19 : our retrospective
Page 10, lane 7: mesalazine
lane 7: The delay between drug introduction and acute pancreatitis was similar....
lane 9: should include DIPI, biliary pancreatitis, auto-immune pancreatitis and duodenal involvment.
lane 12 : of their immunisation for hepatitis 
lane 21 : the low proportion
Page 11, lanes 18 to 20 : it is a result and should be included in the results section
lane 21 : ULN
lane 22 : may be better tolerated
Page 12, lane 1: In our study, one out of four....
-A descriptive Table is necessary and can replace the Table 2
Colums : Whole population, UC, Crohn
Lanes : age sex, severity, localisation, frequency of the extra-intestinal manifestations.....
-Table 3 : I think sulfasalazine should be removed unless you have very good reasons to think that it is  
responsible of DILI
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 comments to the authors.
Unable to assess
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 quality 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 salary 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 publication 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.
No conflict of interest
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 Creative 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