Title: Feasibility, effectiveness, and safety of simultaneous side-by-side deployment of
uncovered self-expandable metal stents for malignant hilar biliary obstruction: a retrospective
single- center study
Version: 1 Date: 14 Jan 2025
Reviewer:  Zhaohui Tang
Reviewer's report:
This paper presents a retrospective, single-center study investigating the feasibility,
effectiveness, and safety of a novel endoscopic approach—simultaneous side-by-side
deployment of uncovered self-expandable metal stents (SEMS)—for the palliation of malignant
hilar biliary obstruction. The study reports excellent technical (100%) and clinical (100%)
success rates, with a relatively low complication rate (13.3%) and promising stent patency.
Additionally, the authors show that combining this approach with the percutaneous-endoscopic
rendezvous technique can be particularly advantageous in challenging anatomical situations.
Overall, the findings suggest that simultaneous side-by-side SEMS placement is a viable and
safe option for biliary drainage in unresectable malignant hilar biliary obstruction.
However, there are still some issues to be addressed before it’s suitable for publication:
1.With only 15 patients and data collected at a single institution, the generalizability of this
study’s findings may be limited.
2.The paper does not compare the proposed technique directly against other established
strategies (e.g., unilateral stenting, sequential stent-in-stent placement), making it difficult to
quantify the benefits over conventional approaches.
3.The retrospective design, along with relatively short and varied patient follow-up durations,
may not fully capture long-term complications or outcomes, thus calling for further prospective
validation.
Title: Feasibility, effectiveness, and safety of simultaneous side-by-side deployment of
uncovered self-expandable metal stents for malignant hilar biliary obstruction: a retrospective
single- center study
Version: 1 Date: 14 Jan 2025
Reviewer:  Zhaohui Tang
Reviewer's report:
This paper presents a retrospective, single-center study investigating the feasibility,
effectiveness, and safety of a novel endoscopic approach—simultaneous side-by-side
deployment of uncovered self-expandable metal stents (SEMS)—for the palliation of malignant
hilar biliary obstruction. The study reports excellent technical (100%) and clinical (100%)
success rates, with a relatively low complication rate (13.3%) and promising stent patency.
Additionally, the authors show that combining this approach with the percutaneous-endoscopic
rendezvous technique can be particularly advantageous in challenging anatomical situations.
Overall, the findings suggest that simultaneous side-by-side SEMS placement is a viable and
safe option for biliary drainage in unresectable malignant hilar biliary obstruction.
However, there are still some issues to be addressed before it’s suitable for publication:
1.With only 15 patients and data collected at a single institution, the generalizability of this
study’s findings may be limited.
2.The paper does not compare the proposed technique directly against other established
strategies (e.g., unilateral stenting, sequential stent-in-stent placement), making it difficult to
quantify the benefits over conventional approaches.
3.The retrospective design, along with relatively short and varied patient follow-up durations,
may not fully capture long-term complications or outcomes, thus calling for further prospective
validation.
Please review this paper.
user
Title: Feasibility, effectiveness, and safety of simultaneous side-by-side deployment of
uncovered self-expandable metal stents for malignant hilar biliary obstruction: a retrospective
single- center study
Version: 1 Date: 14 Jan 2025
Reviewer:  Zhaohui Tang
Reviewer's report:
This paper presents a retrospective, single-center study investigating the feasibility,
effectiveness, and safety of a novel endoscopic approach—simultaneous side-by-side
deployment of uncovered self-expandable metal stents (SEMS)—for the palliation of malignant
hilar biliary obstruction. The study reports excellent technical (100%) and clinical (100%)
success rates, with a relatively low complication rate (13.3%) and promising stent patency.
Additionally, the authors show that combining this approach with the percutaneous-endoscopic
rendezvous technique can be particularly advantageous in challenging anatomical situations.
Overall, the findings suggest that simultaneous side-by-side SEMS placement is a viable and
safe option for biliary drainage in unresectable malignant hilar biliary obstruction.
However, there are still some issues to be addressed before it’s suitable for publication:
1.With only 15 patients and data collected at a single institution, the generalizability of this
study’s findings may be limited.
2.The paper does not compare the proposed technique directly against other established
strategies (e.g., unilateral stenting, sequential stent-in-stent placement), making it difficult to
quantify the benefits over conventional approaches.
3.The retrospective design, along with relatively short and varied patient follow-up durations,
may not fully capture long-term complications or outcomes, thus calling for further prospective
validation.
assistant