Title: The usefulness of percutaneous bile duct metal stent insertion for malignant biliary
obstruction: a retrospective study
Version: 2 Date: 13 Jan 2025
Reviewer's report:
1. It is unacceptable that the authors try to prove a scientifically medical perspective by referring
a study reported more than 20 years ago, which is the first sentence of the article. And most of
the references are very old.
2. Considering that the method in this study was first reported 40 years ago and reported 20 years
ago in Lancet,  and it is still not a popular and regular medical therapy nowadays, even in this
study only 14 patients during 8 years, there is a reasonable explanation of the above situation,
which is “percutaneous bile duct metal stent insertion for malignant biliary obstruction” is  not
useful  and popular in the real medical treatment. The conclusion means that this study may be
with little scientific value.
3. The design of this study is too simple to be published in a magazine with high quality. There
was no comparison test with other treatments, for example, the PTCD.  And there was no follow-
up data to evaluate the long-term complications, such as recurrent fever due to the obstruction
of the stent. Since the sample is very small, a comprehensive analysis should be conducted.
4. To be honest, in China, it is regular to have a bile duct stent insertion for the patients who have
undergone biliary or the digestive tract reconstruction, such as LPD and other gastric surgeries,
by the endoscopic approach.
Title: The usefulness of percutaneous bile duct metal stent insertion for malignant biliary
obstruction: a retrospective study
Version: 2 Date: 13 Jan 2025
Reviewer's report:
1. It is unacceptable that the authors try to prove a scientifically medical perspective by referring
a study reported more than 20 years ago, which is the first sentence of the article. And most of
the references are very old.
2. Considering that the method in this study was first reported 40 years ago and reported 20 years
ago in Lancet,  and it is still not a popular and regular medical therapy nowadays, even in this
study only 14 patients during 8 years, there is a reasonable explanation of the above situation,
which is “percutaneous bile duct metal stent insertion for malignant biliary obstruction” is  not
useful  and popular in the real medical treatment. The conclusion means that this study may be
with little scientific value.
3. The design of this study is too simple to be published in a magazine with high quality. There
was no comparison test with other treatments, for example, the PTCD.  And there was no follow-
up data to evaluate the long-term complications, such as recurrent fever due to the obstruction
of the stent. Since the sample is very small, a comprehensive analysis should be conducted.
4. To be honest, in China, it is regular to have a bile duct stent insertion for the patients who have
undergone biliary or the digestive tract reconstruction, such as LPD and other gastric surgeries,
by the endoscopic approach.
Please review this paper.
user
Title: The usefulness of percutaneous bile duct metal stent insertion for malignant biliary
obstruction: a retrospective study
Version: 2 Date: 13 Jan 2025
Reviewer's report:
1. It is unacceptable that the authors try to prove a scientifically medical perspective by referring
a study reported more than 20 years ago, which is the first sentence of the article. And most of
the references are very old.
2. Considering that the method in this study was first reported 40 years ago and reported 20 years
ago in Lancet,  and it is still not a popular and regular medical therapy nowadays, even in this
study only 14 patients during 8 years, there is a reasonable explanation of the above situation,
which is “percutaneous bile duct metal stent insertion for malignant biliary obstruction” is  not
useful  and popular in the real medical treatment. The conclusion means that this study may be
with little scientific value.
3. The design of this study is too simple to be published in a magazine with high quality. There
was no comparison test with other treatments, for example, the PTCD.  And there was no follow-
up data to evaluate the long-term complications, such as recurrent fever due to the obstruction
of the stent. Since the sample is very small, a comprehensive analysis should be conducted.
4. To be honest, in China, it is regular to have a bile duct stent insertion for the patients who have
undergone biliary or the digestive tract reconstruction, such as LPD and other gastric surgeries,
by the endoscopic approach.
assistant