Title: Surgery for acute cholecystitis in severely comorbid patients: A population-based study
on acute cholecystitis
Version: 1 Date: 05 Jul 2022
Reviewer's report:
I would congratulate the authors for providing very important information regarding surgery
for acute cholecystsitis in severe systemic disease from national registry data. Please find my
comments.
1. The issue with registry-based data being heterogeneity and discretion of physician for
cholecystectomy. If a surgeon feels a patient deemed non-suitable for emergency surgery, patient
will be managed conservatively and undergo elective surgery. This is also reflected in the data
provided as patients managed non-operatively were older and sicker. So among ASA III only
those patients underwent emergency surgery who were relatively stable. This issue needs to be
discussed.
2. In the abstract the authors should remove “complicating risk benefit analysis” from the
conclusion as this is not a part of this study.
3. Since ASA groups differ significantly in age, a subgroup analysis of mild and severe
complication on the basis of age (< 65-70 and >65-70) among different ASA group should be
done.
Title: Surgery for acute cholecystitis in severely comorbid patients: A population-based study
on acute cholecystitis
Version: 1 Date: 05 Jul 2022
Reviewer's report:
I would congratulate the authors for providing very important information regarding surgery
for acute cholecystsitis in severe systemic disease from national registry data. Please find my
comments.
1. The issue with registry-based data being heterogeneity and discretion of physician for
cholecystectomy. If a surgeon feels a patient deemed non-suitable for emergency surgery, patient
will be managed conservatively and undergo elective surgery. This is also reflected in the data
provided as patients managed non-operatively were older and sicker. So among ASA III only
those patients underwent emergency surgery who were relatively stable. This issue needs to be
discussed.
2. In the abstract the authors should remove “complicating risk benefit analysis” from the
conclusion as this is not a part of this study.
3. Since ASA groups differ significantly in age, a subgroup analysis of mild and severe
complication on the basis of age (< 65-70 and >65-70) among different ASA group should be
done.
Please review this paper.
user
Title: Surgery for acute cholecystitis in severely comorbid patients: A population-based study
on acute cholecystitis
Version: 1 Date: 05 Jul 2022
Reviewer's report:
I would congratulate the authors for providing very important information regarding surgery
for acute cholecystsitis in severe systemic disease from national registry data. Please find my
comments.
1. The issue with registry-based data being heterogeneity and discretion of physician for
cholecystectomy. If a surgeon feels a patient deemed non-suitable for emergency surgery, patient
will be managed conservatively and undergo elective surgery. This is also reflected in the data
provided as patients managed non-operatively were older and sicker. So among ASA III only
those patients underwent emergency surgery who were relatively stable. This issue needs to be
discussed.
2. In the abstract the authors should remove “complicating risk benefit analysis” from the
conclusion as this is not a part of this study.
3. Since ASA groups differ significantly in age, a subgroup analysis of mild and severe
complication on the basis of age (< 65-70 and >65-70) among different ASA group should be
done.
assistant