Reviewer ’s report  
 
Title: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 2 Date: 10 May 2020  
  
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
Thank you to the a uthors to have responded to the different comments  
Some are pending.  
The main point is how to define success and failure. The definition was given at page 4. 
When I use this definition and analyse the figure 2, I can see that 10 patients had stricture 
recurrence. Of these 10, 9 were asymptomatic and 5 of them had cholestatic LFTs. Does it 
means that you consider a failure the 4 patients who had a stenosis with normal LFT ? I 
would consider that these 4 patients had a resolution of their stenosis. This sten osis is 
radiologically significant but clinically not significant. We can imagine that the diameter of 
the anastomosis is lower than the diameter above and below without inducing a clinically 
significant cholestasis = no bile duct dilation and no cholestas is. I will be happy to hear your 
point of view.  
 
-Page 6, lanes 105 and 106: I would suggest the median and IQR  
 
-Page 7 lane 18: jaundiced instead jaundice  
 
-Page 7, lane 32: Of the 62 patients, 46 had an asymptomatic stricture. 18 of thse 46 patients 
had abnormal LFT. Do you mean that 28 patients had normal LFT and that you consider that 
we need to stent the bile duct of these patients ? Do you confirm ?  
 
-Page 10, lane 40 : was lower or lowered. Add parenthese please.  
 
-Table 3: For me, what is the most interesting is the number of patients with normal or 
abnormal values and not the mean values  
 
-Figure 2: can you modify the sentence 1 was jaundice and improved after sphincterotomy by 
1 had jaundice or was jaundiced........(maybe my English is not good enough!!!)  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
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 writ ten 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 reim bursements, 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 fro m 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  
 
 
 
 
 
 
 
 
 
Reviewer Publication Consent. 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 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confide ntial comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you can include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please publish my name with my report.  
Reviewer ’s report  
 
Title: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 2 Date: 10 May 2020  
  
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
Thank you to the a uthors to have responded to the different comments  
Some are pending.  
The main point is how to define success and failure. The definition was given at page 4. 
When I use this definition and analyse the figure 2, I can see that 10 patients had stricture 
recurrence. Of these 10, 9 were asymptomatic and 5 of them had cholestatic LFTs. Does it 
means that you consider a failure the 4 patients who had a stenosis with normal LFT ? I 
would consider that these 4 patients had a resolution of their stenosis. This sten osis is 
radiologically significant but clinically not significant. We can imagine that the diameter of 
the anastomosis is lower than the diameter above and below without inducing a clinically 
significant cholestasis = no bile duct dilation and no cholestas is. I will be happy to hear your 
point of view.  
 
-Page 6, lanes 105 and 106: I would suggest the median and IQR  
 
-Page 7 lane 18: jaundiced instead jaundice  
 
-Page 7, lane 32: Of the 62 patients, 46 had an asymptomatic stricture. 18 of thse 46 patients 
had abnormal LFT. Do you mean that 28 patients had normal LFT and that you consider that 
we need to stent the bile duct of these patients ? Do you confirm ?  
 
-Page 10, lane 40 : was lower or lowered. Add parenthese please.  
 
-Table 3: For me, what is the most interesting is the number of patients with normal or 
abnormal values and not the mean values  
 
-Figure 2: can you modify the sentence 1 was jaundice and improved after sphincterotomy by 
1 had jaundice or was jaundiced........(maybe my English is not good enough!!!)  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
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 writ ten 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 reim bursements, 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 fro m 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  
 
 
 
 
 
 
 
 
 
Reviewer Publication Consent. 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 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confide ntial comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you can include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please publish my name with my report.  
Please review this paper.
user
Reviewer ’s report  
 
Title: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 2 Date: 10 May 2020  
  
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
Thank you to the a uthors to have responded to the different comments  
Some are pending.  
The main point is how to define success and failure. The definition was given at page 4. 
When I use this definition and analyse the figure 2, I can see that 10 patients had stricture 
recurrence. Of these 10, 9 were asymptomatic and 5 of them had cholestatic LFTs. Does it 
means that you consider a failure the 4 patients who had a stenosis with normal LFT ? I 
would consider that these 4 patients had a resolution of their stenosis. This sten osis is 
radiologically significant but clinically not significant. We can imagine that the diameter of 
the anastomosis is lower than the diameter above and below without inducing a clinically 
significant cholestasis = no bile duct dilation and no cholestas is. I will be happy to hear your 
point of view.  
 
-Page 6, lanes 105 and 106: I would suggest the median and IQR  
 
-Page 7 lane 18: jaundiced instead jaundice  
 
-Page 7, lane 32: Of the 62 patients, 46 had an asymptomatic stricture. 18 of thse 46 patients 
had abnormal LFT. Do you mean that 28 patients had normal LFT and that you consider that 
we need to stent the bile duct of these patients ? Do you confirm ?  
 
-Page 10, lane 40 : was lower or lowered. Add parenthese please.  
 
-Table 3: For me, what is the most interesting is the number of patients with normal or 
abnormal values and not the mean values  
 
-Figure 2: can you modify the sentence 1 was jaundice and improved after sphincterotomy by 
1 had jaundice or was jaundiced........(maybe my English is not good enough!!!)  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
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 writ ten 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 reim bursements, 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 fro m 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  
 
 
 
 
 
 
 
 
 
Reviewer Publication Consent. 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 ) if 
this manuscript  is accepted for publication. Any comments that I do not wish to be included 
in the published  report have been included as confide ntial comments to the editor, which will 
not be published.  If you are not happy for us to publish this report, please contact the editorial 
office before completing  the review.  If you wish, you can include your name in your 
published report. Please note you must  decide whether to include your name at the start of the 
process and confirm this decision whenever  prompted. If you change your decision later, we 
will not be able to publish your name.  
 
I agree to the terms of the CC -BY 4.0 license; please publish my name with my report.  
assistant