Reviewer's report
Title:Comparison of clinical course and outcome of acute pancreatitis according
to the two main etiologies: alcohol and gallstone
Version:2Date:16 March 2015
Reviewer: Raffaele Pezzilli
Reviewer's report:
The authors aimed to investigate the difference between the clinical course of
alcoholic and gallstone acute pancreatitis in 126 patients of the originally 153
retrospectively selected. The between the two groups were the incidence of
pseudocysts that was higher in alcohol group that in the biliary group, CTSI
higher in the alcohol group tan in the biliary group, the organ failure persisting
beyond 48 hours higher in the alcohol group than in the biliary group and
mortality also higher in the alcohol the in the biliary group.
Major comments
1. My main concern is the retrospective nature of the study that suffers of a bias
of selection.
2. The authors used the modified Atlanta criteria; however, in their series there
are no walled-off necrosis and this should be explained.
3. In addition, according to the modified Atlanta criteria, the incidence of
pseudocyst is lower than that of walled-off necrosis and the definition of
pseudocyst is stricter than that of original Atlanta classification system. Please
comment.
4. The high number of pseudocysts in alcoholic pancreatitis may be related to a
chronic pancreatitis: how many attack of pancreatitis there were in the alcoholic
group; in other words, there was a difference in recurrence of pancreatitis in the
two groups of patients studied. In the follow-up how of alcoholic patients
developed chronic pancreatitis.
5. Pseudocyst is a late complication of acute pancreatitis: the authors should
report the time between the diagnosis of acute pancreatitis and the diagnosis of
pseudocyst.
6. The authors stated "We analyzed amylase, lipase, and lipase/amylase ratio
when two patients with renal failure in the biliary group were excluded." the
sentence has no sense and should be reworded.
7. Why the authors evaluate the lipase/amylase ratio? There is evidence that this
parameter is not useful to distinguish between alcoholic and non-alcoholic
pancreatitis.
8. References should be updated and more paper should be cited according to
accuracy of lipase/amylase ratio.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
None to declare
Reviewer's report
Title:Comparison of clinical course and outcome of acute pancreatitis according
to the two main etiologies: alcohol and gallstone
Version:2Date:16 March 2015
Reviewer: Raffaele Pezzilli
Reviewer's report:
The authors aimed to investigate the difference between the clinical course of
alcoholic and gallstone acute pancreatitis in 126 patients of the originally 153
retrospectively selected. The between the two groups were the incidence of
pseudocysts that was higher in alcohol group that in the biliary group, CTSI
higher in the alcohol group tan in the biliary group, the organ failure persisting
beyond 48 hours higher in the alcohol group than in the biliary group and
mortality also higher in the alcohol the in the biliary group.
Major comments
1. My main concern is the retrospective nature of the study that suffers of a bias
of selection.
2. The authors used the modified Atlanta criteria; however, in their series there
are no walled-off necrosis and this should be explained.
3. In addition, according to the modified Atlanta criteria, the incidence of
pseudocyst is lower than that of walled-off necrosis and the definition of
pseudocyst is stricter than that of original Atlanta classification system. Please
comment.
4. The high number of pseudocysts in alcoholic pancreatitis may be related to a
chronic pancreatitis: how many attack of pancreatitis there were in the alcoholic
group; in other words, there was a difference in recurrence of pancreatitis in the
two groups of patients studied. In the follow-up how of alcoholic patients
developed chronic pancreatitis.
5. Pseudocyst is a late complication of acute pancreatitis: the authors should
report the time between the diagnosis of acute pancreatitis and the diagnosis of
pseudocyst.
6. The authors stated "We analyzed amylase, lipase, and lipase/amylase ratio
when two patients with renal failure in the biliary group were excluded." the
sentence has no sense and should be reworded.
7. Why the authors evaluate the lipase/amylase ratio? There is evidence that this
parameter is not useful to distinguish between alcoholic and non-alcoholic
pancreatitis.
8. References should be updated and more paper should be cited according to
accuracy of lipase/amylase ratio.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
None to declare
Please review this paper.
user
Reviewer's report
Title:Comparison of clinical course and outcome of acute pancreatitis according
to the two main etiologies: alcohol and gallstone
Version:2Date:16 March 2015
Reviewer: Raffaele Pezzilli
Reviewer's report:
The authors aimed to investigate the difference between the clinical course of
alcoholic and gallstone acute pancreatitis in 126 patients of the originally 153
retrospectively selected. The between the two groups were the incidence of
pseudocysts that was higher in alcohol group that in the biliary group, CTSI
higher in the alcohol group tan in the biliary group, the organ failure persisting
beyond 48 hours higher in the alcohol group than in the biliary group and
mortality also higher in the alcohol the in the biliary group.
Major comments
1. My main concern is the retrospective nature of the study that suffers of a bias
of selection.
2. The authors used the modified Atlanta criteria; however, in their series there
are no walled-off necrosis and this should be explained.
3. In addition, according to the modified Atlanta criteria, the incidence of
pseudocyst is lower than that of walled-off necrosis and the definition of
pseudocyst is stricter than that of original Atlanta classification system. Please
comment.
4. The high number of pseudocysts in alcoholic pancreatitis may be related to a
chronic pancreatitis: how many attack of pancreatitis there were in the alcoholic
group; in other words, there was a difference in recurrence of pancreatitis in the
two groups of patients studied. In the follow-up how of alcoholic patients
developed chronic pancreatitis.
5. Pseudocyst is a late complication of acute pancreatitis: the authors should
report the time between the diagnosis of acute pancreatitis and the diagnosis of
pseudocyst.
6. The authors stated "We analyzed amylase, lipase, and lipase/amylase ratio
when two patients with renal failure in the biliary group were excluded." the
sentence has no sense and should be reworded.
7. Why the authors evaluate the lipase/amylase ratio? There is evidence that this
parameter is not useful to distinguish between alcoholic and non-alcoholic
pancreatitis.
8. References should be updated and more paper should be cited according to
accuracy of lipase/amylase ratio.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
None to declare
assistant