Reviewer's report
Title:Comparison of the usefulness of endoscopic papillary large-balloon dilation
with endoscopic sphincterotomy for large and multiple common bile duct stones
Version:3Date:12 January 2015
Reviewer: Muhammad Hasan
Reviewer's report:
1- In abstract line 8. EPLBD has been abbreviated wrong as EBLBD.
2- The technique of ERCP is very confusing. In two places: one in section
Endoscopic technique (line 19-21) and second in discussion portion "in the area
of discussion of rate of pancreatitis" it appears like sphincterotomy was
performed prior to each EPLBD. If sphincterotomy was performed before each
EPLBD then it needs to mentioned clearly in the whole paper. In that case it
would be comparison of two groups which would be EST vs. EST+EPLBD.
If however, above is not the case and its pure comparison of EST vs. EPLBD
then I am not sure these results are applicable to Western hemisphere. As two of
the meta-analysis (TH. Baron. AJG 2004 and Weinberg BM. Cochrane Data
Base. 2006) have clearly indicated higher risk of pancreatitis (including fatal
cases) with EPBLD only therapy and should not performed as a sole technique
(without EST) unless special and unique circumstances.
3- Discussion of the paper needs to be more concise and shorter.
4- It also needs to very clearly stated that these results are not applicable to
patients less than age of 60 (per authors it was not a first line treatment for
younger than 60 years of age)
5- All patients received protease inhibitors and antimicrobials to prevents
pancreatitis. Whats the evidence for that??
6- Mean duration of hospitalization was 20.2 days in EST group and 17.7 days in
EPLBD. If complete clearance of stones was more than 88% in EPLBD group
then I unable to comprehend that long duration of hospitalization (more than 17
days of hospitalization just for an ERCP which usually is an out patient
procedure. WOW!!!). Any explanation of such a long duration of hospitalization in
both groups?
7. Can authors elaborate what was hypothesized reason of such high rate of
pancreatitis: 22.2% in EST, as compared to only 5.9% in EPBLD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Comparison of the usefulness of endoscopic papillary large-balloon dilation
with endoscopic sphincterotomy for large and multiple common bile duct stones
Version:3Date:12 January 2015
Reviewer: Muhammad Hasan
Reviewer's report:
1- In abstract line 8. EPLBD has been abbreviated wrong as EBLBD.
2- The technique of ERCP is very confusing. In two places: one in section
Endoscopic technique (line 19-21) and second in discussion portion "in the area
of discussion of rate of pancreatitis" it appears like sphincterotomy was
performed prior to each EPLBD. If sphincterotomy was performed before each
EPLBD then it needs to mentioned clearly in the whole paper. In that case it
would be comparison of two groups which would be EST vs. EST+EPLBD.
If however, above is not the case and its pure comparison of EST vs. EPLBD
then I am not sure these results are applicable to Western hemisphere. As two of
the meta-analysis (TH. Baron. AJG 2004 and Weinberg BM. Cochrane Data
Base. 2006) have clearly indicated higher risk of pancreatitis (including fatal
cases) with EPBLD only therapy and should not performed as a sole technique
(without EST) unless special and unique circumstances.
3- Discussion of the paper needs to be more concise and shorter.
4- It also needs to very clearly stated that these results are not applicable to
patients less than age of 60 (per authors it was not a first line treatment for
younger than 60 years of age)
5- All patients received protease inhibitors and antimicrobials to prevents
pancreatitis. Whats the evidence for that??
6- Mean duration of hospitalization was 20.2 days in EST group and 17.7 days in
EPLBD. If complete clearance of stones was more than 88% in EPLBD group
then I unable to comprehend that long duration of hospitalization (more than 17
days of hospitalization just for an ERCP which usually is an out patient
procedure. WOW!!!). Any explanation of such a long duration of hospitalization in
both groups?
7. Can authors elaborate what was hypothesized reason of such high rate of
pancreatitis: 22.2% in EST, as compared to only 5.9% in EPBLD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Comparison of the usefulness of endoscopic papillary large-balloon dilation
with endoscopic sphincterotomy for large and multiple common bile duct stones
Version:3Date:12 January 2015
Reviewer: Muhammad Hasan
Reviewer's report:
1- In abstract line 8. EPLBD has been abbreviated wrong as EBLBD.
2- The technique of ERCP is very confusing. In two places: one in section
Endoscopic technique (line 19-21) and second in discussion portion "in the area
of discussion of rate of pancreatitis" it appears like sphincterotomy was
performed prior to each EPLBD. If sphincterotomy was performed before each
EPLBD then it needs to mentioned clearly in the whole paper. In that case it
would be comparison of two groups which would be EST vs. EST+EPLBD.
If however, above is not the case and its pure comparison of EST vs. EPLBD
then I am not sure these results are applicable to Western hemisphere. As two of
the meta-analysis (TH. Baron. AJG 2004 and Weinberg BM. Cochrane Data
Base. 2006) have clearly indicated higher risk of pancreatitis (including fatal
cases) with EPBLD only therapy and should not performed as a sole technique
(without EST) unless special and unique circumstances.
3- Discussion of the paper needs to be more concise and shorter.
4- It also needs to very clearly stated that these results are not applicable to
patients less than age of 60 (per authors it was not a first line treatment for
younger than 60 years of age)
5- All patients received protease inhibitors and antimicrobials to prevents
pancreatitis. Whats the evidence for that??
6- Mean duration of hospitalization was 20.2 days in EST group and 17.7 days in
EPLBD. If complete clearance of stones was more than 88% in EPLBD group
then I unable to comprehend that long duration of hospitalization (more than 17
days of hospitalization just for an ERCP which usually is an out patient
procedure. WOW!!!). Any explanation of such a long duration of hospitalization in
both groups?
7. Can authors elaborate what was hypothesized reason of such high rate of
pancreatitis: 22.2% in EST, as compared to only 5.9% in EPBLD.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant