Title: Impact of cholangitis on survival of patients with malignant biliary obstruction treated
with percutaneous transhepatic biliary drainage
Version: 2 Date: 19 Dec 2022
Reviewer's report:
In this study Niemela J and colleagues have explored impact of cholangitis on survival
of patients with malignant biliary obstruction undergoing percutaneous transhepatic biliary
drainage. Overall, 588 patients were enrolled; 156 patients had cholangitis before PTBD, 215
had cholangitis after PTBD and 217 patients were without cholangitis. Patients with cholangitis
prior to PTBD had lower survival compared to patients with cholangitis after PTBD or without
cholangitis.
Major concerns:
1. Authors should consider comparing individual groups to find significance like between group
with cholangitis prior to PTBD, without prior PTBD or without cholangitis.
2. Patients with cholangitis prior to PTBD had poorer performance status compared to other two
groups. Whether that was the major contributing factor for overall poor median survival that
should be explored.
3. What were the causes of cholangitis after PTBD should be mentioned in the results like due
to blockage of the PTBD catheter or slippage of PTBD catheter or inadequately drained system.
4. Median time from PTBD insertion to onset of cholangitis should be mentioned.
5. What management was used for management of cholangitis after PTBD should be mentioned
like change of PTBD catheter, upgradation of PTBD catheter or insertion of metallic SEMS.
6. What was the catheter diameter used during PTBD should also be mentioned and whether
metallic stent placement was done during initial setting or subsequent setting should also be
mentioned.
7. Many details of patient’s are mentioned in methodology or discussion section which should
be removed and mentioned in the results section.
8. Tables should be re-arranged at the end of the manuscript not embedded in the results section.
Title: Impact of cholangitis on survival of patients with malignant biliary obstruction treated
with percutaneous transhepatic biliary drainage
Version: 2 Date: 19 Dec 2022
Reviewer's report:
In this study Niemela J and colleagues have explored impact of cholangitis on survival
of patients with malignant biliary obstruction undergoing percutaneous transhepatic biliary
drainage. Overall, 588 patients were enrolled; 156 patients had cholangitis before PTBD, 215
had cholangitis after PTBD and 217 patients were without cholangitis. Patients with cholangitis
prior to PTBD had lower survival compared to patients with cholangitis after PTBD or without
cholangitis.
Major concerns:
1. Authors should consider comparing individual groups to find significance like between group
with cholangitis prior to PTBD, without prior PTBD or without cholangitis.
2. Patients with cholangitis prior to PTBD had poorer performance status compared to other two
groups. Whether that was the major contributing factor for overall poor median survival that
should be explored.
3. What were the causes of cholangitis after PTBD should be mentioned in the results like due
to blockage of the PTBD catheter or slippage of PTBD catheter or inadequately drained system.
4. Median time from PTBD insertion to onset of cholangitis should be mentioned.
5. What management was used for management of cholangitis after PTBD should be mentioned
like change of PTBD catheter, upgradation of PTBD catheter or insertion of metallic SEMS.
6. What was the catheter diameter used during PTBD should also be mentioned and whether
metallic stent placement was done during initial setting or subsequent setting should also be
mentioned.
7. Many details of patient’s are mentioned in methodology or discussion section which should
be removed and mentioned in the results section.
8. Tables should be re-arranged at the end of the manuscript not embedded in the results section.
Please review this paper.
user
Title: Impact of cholangitis on survival of patients with malignant biliary obstruction treated
with percutaneous transhepatic biliary drainage
Version: 2 Date: 19 Dec 2022
Reviewer's report:
In this study Niemela J and colleagues have explored impact of cholangitis on survival
of patients with malignant biliary obstruction undergoing percutaneous transhepatic biliary
drainage. Overall, 588 patients were enrolled; 156 patients had cholangitis before PTBD, 215
had cholangitis after PTBD and 217 patients were without cholangitis. Patients with cholangitis
prior to PTBD had lower survival compared to patients with cholangitis after PTBD or without
cholangitis.
Major concerns:
1. Authors should consider comparing individual groups to find significance like between group
with cholangitis prior to PTBD, without prior PTBD or without cholangitis.
2. Patients with cholangitis prior to PTBD had poorer performance status compared to other two
groups. Whether that was the major contributing factor for overall poor median survival that
should be explored.
3. What were the causes of cholangitis after PTBD should be mentioned in the results like due
to blockage of the PTBD catheter or slippage of PTBD catheter or inadequately drained system.
4. Median time from PTBD insertion to onset of cholangitis should be mentioned.
5. What management was used for management of cholangitis after PTBD should be mentioned
like change of PTBD catheter, upgradation of PTBD catheter or insertion of metallic SEMS.
6. What was the catheter diameter used during PTBD should also be mentioned and whether
metallic stent placement was done during initial setting or subsequent setting should also be
mentioned.
7. Many details of patient’s are mentioned in methodology or discussion section which should
be removed and mentioned in the results section.
8. Tables should be re-arranged at the end of the manuscript not embedded in the results section.
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