Reviewer ’s report  
Title: Endoscopic Retrograde Cholangiopancreatography in the Elderly: Results of a 
Retrospective  Study and a Ge riatricians' Point of View  
 
Version: 0 Date: 27 Dec 2017  
 
Reviewer: Leena Kylänpää  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versi ons of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
This is a nicely written paper about ERCP procedures safety for  elderly. The issue is becoming 
more and more important since number of elderly people is increasing and also the need for 
ERCP for them.  
The main problem with the study is that no deep sedation is used even if many of the patients 
were in poor condition. That, in my opinion, should not happen nowadays. If the paper is 
accepted for publication, this matter should be highlighted and discussed.  
- In background line 10 sphincterotomy word should be corrected  
- In chapter "ERCP: procedures, success rate and com plications" it is mentioned that in 22 
patients , cannulation was not successful.  They only give a reason for that for 6 out of 22  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the a uthors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to t he authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary  from an  
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publicatio n of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to  any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Endoscopic Retrograde Cholangiopancreatography in the Elderly: Results of a 
Retrospective  Study and a Ge riatricians' Point of View  
 
Version: 0 Date: 27 Dec 2017  
 
Reviewer: Leena Kylänpää  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versi ons of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
This is a nicely written paper about ERCP procedures safety for  elderly. The issue is becoming 
more and more important since number of elderly people is increasing and also the need for 
ERCP for them.  
The main problem with the study is that no deep sedation is used even if many of the patients 
were in poor condition. That, in my opinion, should not happen nowadays. If the paper is 
accepted for publication, this matter should be highlighted and discussed.  
- In background line 10 sphincterotomy word should be corrected  
- In chapter "ERCP: procedures, success rate and com plications" it is mentioned that in 22 
patients , cannulation was not successful.  They only give a reason for that for 6 out of 22  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the a uthors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to t he authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary  from an  
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publicatio n of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to  any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Endoscopic Retrograde Cholangiopancreatography in the Elderly: Results of a 
Retrospective  Study and a Ge riatricians' Point of View  
 
Version: 0 Date: 27 Dec 2017  
 
Reviewer: Leena Kylänpää  
 
Reviewer's report:  
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versi ons of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
This is a nicely written paper about ERCP procedures safety for  elderly. The issue is becoming 
more and more important since number of elderly people is increasing and also the need for 
ERCP for them.  
The main problem with the study is that no deep sedation is used even if many of the patients 
were in poor condition. That, in my opinion, should not happen nowadays. If the paper is 
accepted for publication, this matter should be highlighted and discussed.  
- In background line 10 sphincterotomy word should be corrected  
- In chapter "ERCP: procedures, success rate and com plications" it is mentioned that in 22 
patients , cannulation was not successful.  They only give a reason for that for 6 out of 22  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the a uthors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to t he authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary  from an  
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publicatio n of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to  any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication,  my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant