Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 0 Date: 03 Sep 2024
Reviewer's report:
This manuscript "Efficacy of laparoscopic retroperitoneale pancreayic necrosectomy for treating
duodenal fistula in patients with infected pancreatic necrosis: A single-center retrospective
cohort study" interestingly approaches a difficult and relevant disease, whose treatment is
complex and multidisciplinary.
The topic is, as previously said, interesting and the paper could be clinically relevant, but presents
major issues that make the study difficult to understand and should be modified:
1. Inclusion and exclusion criteria are confused and repeated in the "methods" section, making
it difficult for the reader to understand the final cohort. Description of the step up approach in
the "methods" section is unnecessary, since the patients in the considered cohort all underwent
surgical intervention.
2. The diagnosis of duodenal fistula is confused. At page 6 there is a distinction between
preoperative suspicion (1- yellow digestive fluid or white nutritional fluid in the abdominal
drainage) and two addictional methods (2-endoscopic examination, 3- radiology with
gastric/duodenal contrast), consequentialy considered as postoperative: while endoscopic and
radiological examination can give an objective diagnosis and can distinguish between duodenal
or other gastrointestinal fistulas, the first method is very subjective and should not be considered.
Moreover, since the paper aims to evaluate laparoscopic necrosectomy in the treatment of
infected pancreatic necrosis with duodenal fistula, the presence or absence of duodenal fistula
should be assesed before or during surgery. As a consequence, patients with post-surgical
duodenal fistula should be excluded.
3. The description of propensity score match analysis should be inserted in "statistical analysis"
and not repeated at page 9.
4. The title does not exactly match the content of the paper, since the aim of the present research
is to treat pancreatic necrosis in patients with concurrent duodenal fistula (page 4), and should
be modified.
Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 0 Date: 03 Sep 2024
Reviewer's report:
This manuscript "Efficacy of laparoscopic retroperitoneale pancreayic necrosectomy for treating
duodenal fistula in patients with infected pancreatic necrosis: A single-center retrospective
cohort study" interestingly approaches a difficult and relevant disease, whose treatment is
complex and multidisciplinary.
The topic is, as previously said, interesting and the paper could be clinically relevant, but presents
major issues that make the study difficult to understand and should be modified:
1. Inclusion and exclusion criteria are confused and repeated in the "methods" section, making
it difficult for the reader to understand the final cohort. Description of the step up approach in
the "methods" section is unnecessary, since the patients in the considered cohort all underwent
surgical intervention.
2. The diagnosis of duodenal fistula is confused. At page 6 there is a distinction between
preoperative suspicion (1- yellow digestive fluid or white nutritional fluid in the abdominal
drainage) and two addictional methods (2-endoscopic examination, 3- radiology with
gastric/duodenal contrast), consequentialy considered as postoperative: while endoscopic and
radiological examination can give an objective diagnosis and can distinguish between duodenal
or other gastrointestinal fistulas, the first method is very subjective and should not be considered.
Moreover, since the paper aims to evaluate laparoscopic necrosectomy in the treatment of
infected pancreatic necrosis with duodenal fistula, the presence or absence of duodenal fistula
should be assesed before or during surgery. As a consequence, patients with post-surgical
duodenal fistula should be excluded.
3. The description of propensity score match analysis should be inserted in "statistical analysis"
and not repeated at page 9.
4. The title does not exactly match the content of the paper, since the aim of the present research
is to treat pancreatic necrosis in patients with concurrent duodenal fistula (page 4), and should
be modified.
Please review this paper.
user
Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 0 Date: 03 Sep 2024
Reviewer's report:
This manuscript "Efficacy of laparoscopic retroperitoneale pancreayic necrosectomy for treating
duodenal fistula in patients with infected pancreatic necrosis: A single-center retrospective
cohort study" interestingly approaches a difficult and relevant disease, whose treatment is
complex and multidisciplinary.
The topic is, as previously said, interesting and the paper could be clinically relevant, but presents
major issues that make the study difficult to understand and should be modified:
1. Inclusion and exclusion criteria are confused and repeated in the "methods" section, making
it difficult for the reader to understand the final cohort. Description of the step up approach in
the "methods" section is unnecessary, since the patients in the considered cohort all underwent
surgical intervention.
2. The diagnosis of duodenal fistula is confused. At page 6 there is a distinction between
preoperative suspicion (1- yellow digestive fluid or white nutritional fluid in the abdominal
drainage) and two addictional methods (2-endoscopic examination, 3- radiology with
gastric/duodenal contrast), consequentialy considered as postoperative: while endoscopic and
radiological examination can give an objective diagnosis and can distinguish between duodenal
or other gastrointestinal fistulas, the first method is very subjective and should not be considered.
Moreover, since the paper aims to evaluate laparoscopic necrosectomy in the treatment of
infected pancreatic necrosis with duodenal fistula, the presence or absence of duodenal fistula
should be assesed before or during surgery. As a consequence, patients with post-surgical
duodenal fistula should be excluded.
3. The description of propensity score match analysis should be inserted in "statistical analysis"
and not repeated at page 9.
4. The title does not exactly match the content of the paper, since the aim of the present research
is to treat pancreatic necrosis in patients with concurrent duodenal fistula (page 4), and should
be modified.
assistant