Reviewer ’s report  
 
Title: Duodenal perforations secondary to a migrated biliary plasti c stent successfully treated by 
endoscope: case -report and review of the literature.  
 
Version: 0 Date: 02 Jan 2020  
 
Reviewer: Sang -Heum Park  
 
Reviewer's report:  
 
Thank authors for your interesting cases. As authors described, endoscopic treatment and effects 
of biliary stent -related perforations have been somewhat unusually reported. The following 
points are needed to be more educational;  
 
(1) A more significant issue in this paper is authors' opinion to sugg est the possible causes of 
biliary stent -related perforation, especially in terms of diameter, length and shape of bilary 
plastic stent. Also it would be better to suggest preventive method. In this regard, it is necessary 
to refer to the three cases of th e authors and the previous cases in Table 2 to presume the possible 
causes. However, it is recommended to exclude cases caused by metallic stents in Table 2.  
 
(2) There were no death after the endoscopic treatment fortunately in your cases, but there were 
four deaths in Table 2. A more detailed description of whether the cause of those deaths were 
related to endoscopic technique or other factors will help the reader to understand and to avoid 
such terrible results.  
 
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 th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 c ontent 
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.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 t hat any comments 
which I do not wish to be included in my named report can be in cluded 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: Duodenal perforations secondary to a migrated biliary plasti c stent successfully treated by 
endoscope: case -report and review of the literature.  
 
Version: 0 Date: 02 Jan 2020  
 
Reviewer: Sang -Heum Park  
 
Reviewer's report:  
 
Thank authors for your interesting cases. As authors described, endoscopic treatment and effects 
of biliary stent -related perforations have been somewhat unusually reported. The following 
points are needed to be more educational;  
 
(1) A more significant issue in this paper is authors' opinion to sugg est the possible causes of 
biliary stent -related perforation, especially in terms of diameter, length and shape of bilary 
plastic stent. Also it would be better to suggest preventive method. In this regard, it is necessary 
to refer to the three cases of th e authors and the previous cases in Table 2 to presume the possible 
causes. However, it is recommended to exclude cases caused by metallic stents in Table 2.  
 
(2) There were no death after the endoscopic treatment fortunately in your cases, but there were 
four deaths in Table 2. A more detailed description of whether the cause of those deaths were 
related to endoscopic technique or other factors will help the reader to understand and to avoid 
such terrible results.  
 
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 th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 c ontent 
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.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 t hat any comments 
which I do not wish to be included in my named report can be in cluded 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: Duodenal perforations secondary to a migrated biliary plasti c stent successfully treated by 
endoscope: case -report and review of the literature.  
 
Version: 0 Date: 02 Jan 2020  
 
Reviewer: Sang -Heum Park  
 
Reviewer's report:  
 
Thank authors for your interesting cases. As authors described, endoscopic treatment and effects 
of biliary stent -related perforations have been somewhat unusually reported. The following 
points are needed to be more educational;  
 
(1) A more significant issue in this paper is authors' opinion to sugg est the possible causes of 
biliary stent -related perforation, especially in terms of diameter, length and shape of bilary 
plastic stent. Also it would be better to suggest preventive method. In this regard, it is necessary 
to refer to the three cases of th e authors and the previous cases in Table 2 to presume the possible 
causes. However, it is recommended to exclude cases caused by metallic stents in Table 2.  
 
(2) There were no death after the endoscopic treatment fortunately in your cases, but there were 
four deaths in Table 2. A more detailed description of whether the cause of those deaths were 
related to endoscopic technique or other factors will help the reader to understand and to avoid 
such terrible results.  
 
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 th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 c ontent 
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.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 t hat any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant