Reviewer's report
Title:Is preoperative MRCP necessary for patients with gallstones? An analysis
of the factors related to missed diagnosis of choledocholithiasis by preoperative
ultrasound
Version:2Date:14 June 2015
Reviewer: Ajay Belgaumkar
Reviewer's report:
Major Revisions:
The introduction is too long. Please reference the latest Cochrane reviews
regarding diagnosis of gallstones and CBD stones. There is no need to give
references such as Pg2 Line 26 stating that "laparoscopic cholecystectomy is the
gold standard for treatment of gallstones".
The multiple detailed references regarding utility of MRCP are all from studies
conducted in populations with a much lower incidence of CBD stones and may
not be relevant to the study population.
The aim of the study is stated but it would be preferable, rather than stating the
aim is to determine what factors predict an inaccurate ultrasound, to explain that
the study aims to find predictive factors for patients who would benefit from
MRCP. There is also no context given, regarding the desirability of pre-op
detection with MRCP rather than intraoperative detection with Intra op
cholangiogram.
The Statistical methods include the univariate analysis was performed to look for
factors predictive of either diagnosing or missing CBD stones on USS and shows
that CBD diameter, raised ALT and the presence of acute cholecystitis were the
main factors. There is no attempt at constructing a multivariate model to predict
failure of USS (or need for MRCP).
The correlations do not have any obvious relevance.
Results: Table 1 is redundant, as is Table 3.
Conclusion:
see above.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Is preoperative MRCP necessary for patients with gallstones? An analysis
of the factors related to missed diagnosis of choledocholithiasis by preoperative
ultrasound
Version:2Date:14 June 2015
Reviewer: Ajay Belgaumkar
Reviewer's report:
Major Revisions:
The introduction is too long. Please reference the latest Cochrane reviews
regarding diagnosis of gallstones and CBD stones. There is no need to give
references such as Pg2 Line 26 stating that "laparoscopic cholecystectomy is the
gold standard for treatment of gallstones".
The multiple detailed references regarding utility of MRCP are all from studies
conducted in populations with a much lower incidence of CBD stones and may
not be relevant to the study population.
The aim of the study is stated but it would be preferable, rather than stating the
aim is to determine what factors predict an inaccurate ultrasound, to explain that
the study aims to find predictive factors for patients who would benefit from
MRCP. There is also no context given, regarding the desirability of pre-op
detection with MRCP rather than intraoperative detection with Intra op
cholangiogram.
The Statistical methods include the univariate analysis was performed to look for
factors predictive of either diagnosing or missing CBD stones on USS and shows
that CBD diameter, raised ALT and the presence of acute cholecystitis were the
main factors. There is no attempt at constructing a multivariate model to predict
failure of USS (or need for MRCP).
The correlations do not have any obvious relevance.
Results: Table 1 is redundant, as is Table 3.
Conclusion:
see above.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Is preoperative MRCP necessary for patients with gallstones? An analysis
of the factors related to missed diagnosis of choledocholithiasis by preoperative
ultrasound
Version:2Date:14 June 2015
Reviewer: Ajay Belgaumkar
Reviewer's report:
Major Revisions:
The introduction is too long. Please reference the latest Cochrane reviews
regarding diagnosis of gallstones and CBD stones. There is no need to give
references such as Pg2 Line 26 stating that "laparoscopic cholecystectomy is the
gold standard for treatment of gallstones".
The multiple detailed references regarding utility of MRCP are all from studies
conducted in populations with a much lower incidence of CBD stones and may
not be relevant to the study population.
The aim of the study is stated but it would be preferable, rather than stating the
aim is to determine what factors predict an inaccurate ultrasound, to explain that
the study aims to find predictive factors for patients who would benefit from
MRCP. There is also no context given, regarding the desirability of pre-op
detection with MRCP rather than intraoperative detection with Intra op
cholangiogram.
The Statistical methods include the univariate analysis was performed to look for
factors predictive of either diagnosing or missing CBD stones on USS and shows
that CBD diameter, raised ALT and the presence of acute cholecystitis were the
main factors. There is no attempt at constructing a multivariate model to predict
failure of USS (or need for MRCP).
The correlations do not have any obvious relevance.
Results: Table 1 is redundant, as is Table 3.
Conclusion:
see above.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
assistant