Title: Multicenter analysis of the efficacy of early cholecystectomy and preoperative
cholecystostomy for severe acute cholecystitis: A retrospective study of data from the multi-
institutional database of the Hiroshima Surgical Study Group of Clinical Oncology
Version: 5 Date: 09 Aug 2024
Reviewer:  Ana Gonzalez-Castillo
Reviewer's report:
Dear authors, congratulations for all the work and the valuable results achieved. This is the way
we have to go with Acute Cholecystitis. But, let me make few suggestions:
- Reading methods, I cannot be sure if the quantitative variables follow a normal distribution,
could you please specify? As I can understand the results are in median and IQR, so they are
not following a normal distribution. Describe also the test you use to check the distribution of
the quantitative variables.
- In methods as-well, I am not able to find the indications to perform the PC. Could you
specify? Also in this topic, is important to know if they where transperitoneal, transhepatic, and
if you studied the common biliary duct with a cholangiography through the CP. It is valuable
information for the community.
- In conclusions you should specify that not only PC before cholecystectomy prevent from
bleeding and hospital stay length, the most important one, is the recurrence. You should mention.
- About sintaxis, PC after cholecystectomy could confuse the reader, consider to use PC before
cholecystectomy and to specify clearly that it is CP + Surgery in same admission.
- In Figure one: I am not able to understand it. You could make it more illustrative with numbers
of percentage in each column of may be, you could change it with a Patient Accounting figure,
that it is missing.
Thank you very much for your effort and to study about acute cholecystitis, this results will
improve patients outcomes.
Title: Multicenter analysis of the efficacy of early cholecystectomy and preoperative
cholecystostomy for severe acute cholecystitis: A retrospective study of data from the multi-
institutional database of the Hiroshima Surgical Study Group of Clinical Oncology
Version: 5 Date: 09 Aug 2024
Reviewer:  Ana Gonzalez-Castillo
Reviewer's report:
Dear authors, congratulations for all the work and the valuable results achieved. This is the way
we have to go with Acute Cholecystitis. But, let me make few suggestions:
- Reading methods, I cannot be sure if the quantitative variables follow a normal distribution,
could you please specify? As I can understand the results are in median and IQR, so they are
not following a normal distribution. Describe also the test you use to check the distribution of
the quantitative variables.
- In methods as-well, I am not able to find the indications to perform the PC. Could you
specify? Also in this topic, is important to know if they where transperitoneal, transhepatic, and
if you studied the common biliary duct with a cholangiography through the CP. It is valuable
information for the community.
- In conclusions you should specify that not only PC before cholecystectomy prevent from
bleeding and hospital stay length, the most important one, is the recurrence. You should mention.
- About sintaxis, PC after cholecystectomy could confuse the reader, consider to use PC before
cholecystectomy and to specify clearly that it is CP + Surgery in same admission.
- In Figure one: I am not able to understand it. You could make it more illustrative with numbers
of percentage in each column of may be, you could change it with a Patient Accounting figure,
that it is missing.
Thank you very much for your effort and to study about acute cholecystitis, this results will
improve patients outcomes.
Please review this paper.
user
Title: Multicenter analysis of the efficacy of early cholecystectomy and preoperative
cholecystostomy for severe acute cholecystitis: A retrospective study of data from the multi-
institutional database of the Hiroshima Surgical Study Group of Clinical Oncology
Version: 5 Date: 09 Aug 2024
Reviewer:  Ana Gonzalez-Castillo
Reviewer's report:
Dear authors, congratulations for all the work and the valuable results achieved. This is the way
we have to go with Acute Cholecystitis. But, let me make few suggestions:
- Reading methods, I cannot be sure if the quantitative variables follow a normal distribution,
could you please specify? As I can understand the results are in median and IQR, so they are
not following a normal distribution. Describe also the test you use to check the distribution of
the quantitative variables.
- In methods as-well, I am not able to find the indications to perform the PC. Could you
specify? Also in this topic, is important to know if they where transperitoneal, transhepatic, and
if you studied the common biliary duct with a cholangiography through the CP. It is valuable
information for the community.
- In conclusions you should specify that not only PC before cholecystectomy prevent from
bleeding and hospital stay length, the most important one, is the recurrence. You should mention.
- About sintaxis, PC after cholecystectomy could confuse the reader, consider to use PC before
cholecystectomy and to specify clearly that it is CP + Surgery in same admission.
- In Figure one: I am not able to understand it. You could make it more illustrative with numbers
of percentage in each column of may be, you could change it with a Patient Accounting figure,
that it is missing.
Thank you very much for your effort and to study about acute cholecystitis, this results will
improve patients outcomes.
assistant