Reviewer's report
Title:Cholecystectomy and sphincterotomy in patients with mild acute biliary
pancreatitis in Sweden 1988 - 2003: a nationwide register study
Version: 1Date:4 December 2008
Reviewer: Hein Gooszen
Reviewer's report:
This is a review of the paper “Cholecystectomy and sphincterotomy in patients
with mild acute biliary pancreatitis in Sweden 1988 – 2003: a nationwide register
study” bij
Birger Sandzén et al.
Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
Introduction: “In UK guidelines” should be “In the UK guidelines”
Introduction: “Data from nationwide hospital discharge and death certificate
register were used” shoud read “Data from the nationwide….”
Results: 4 groups are described first here, please already describe them in the
methods section .
Results: please do not mention data with groups 1-4 in the text but rather use
tables.
Please ask a native speaker to check the full text of this paper. At numerous
points in the text words like “the” and “a” are missing
Major Compulsory Revisions
- Introduction:“The complication risk in predicted severe acute biliary pancreatitis,
but not in mild acute biliary pancreatitis (MABP), is reduced by early ERCP with
or without sphincterotomy [5]”. This statement is too strong according to recent
literature, such as Petrov et al, Ann Surg 2008.
- Explain how patients were divided into the four groups: institution policy,
docotor's preference, author's discretion?
- Discussion:
- explain potential biases, like in the subdivision into four groups, were age and
local preference and patient selection for the different approaches may hqave
played a major role by the type of treatment for the specific clinical and
radiological presentation; selection bias and its impact must be discussed here.
- “Thus, for patients with mild gallstone pancreatitis fit for surgery,
cholecystectomy at first admission, with intraoperative cholangiography and
concomitant bile duct exploration if necessary is an appropriate treatment”
Laparoscopic bile duct exploration is not a widely accepted technique and there
countries "in favor" and countries "against" at this point in time. Worldwide
acceptance is unlikely. Intraoperative cholangiography is more widely accepted
but still controversial, even in patients with relatively high risk of common bile
duct stones as most stones will pass spontaneously. Please revise these
paragraphs, using international guidelines +/- meta-analysis/reviews as
references.
- there is a difference in mortality between groups 1-2 and 3-4, please discuss
this difference. Is there another source of bias here, in the sense that the older
the patient, the more restrictive the surgical approach?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:Cholecystectomy and sphincterotomy in patients with mild acute biliary
pancreatitis in Sweden 1988 - 2003: a nationwide register study
Version: 1Date:4 December 2008
Reviewer: Hein Gooszen
Reviewer's report:
This is a review of the paper “Cholecystectomy and sphincterotomy in patients
with mild acute biliary pancreatitis in Sweden 1988 – 2003: a nationwide register
study” bij
Birger Sandzén et al.
Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
Introduction: “In UK guidelines” should be “In the UK guidelines”
Introduction: “Data from nationwide hospital discharge and death certificate
register were used” shoud read “Data from the nationwide….”
Results: 4 groups are described first here, please already describe them in the
methods section .
Results: please do not mention data with groups 1-4 in the text but rather use
tables.
Please ask a native speaker to check the full text of this paper. At numerous
points in the text words like “the” and “a” are missing
Major Compulsory Revisions
- Introduction:“The complication risk in predicted severe acute biliary pancreatitis,
but not in mild acute biliary pancreatitis (MABP), is reduced by early ERCP with
or without sphincterotomy [5]”. This statement is too strong according to recent
literature, such as Petrov et al, Ann Surg 2008.
- Explain how patients were divided into the four groups: institution policy,
docotor's preference, author's discretion?
- Discussion:
- explain potential biases, like in the subdivision into four groups, were age and
local preference and patient selection for the different approaches may hqave
played a major role by the type of treatment for the specific clinical and
radiological presentation; selection bias and its impact must be discussed here.
- “Thus, for patients with mild gallstone pancreatitis fit for surgery,
cholecystectomy at first admission, with intraoperative cholangiography and
concomitant bile duct exploration if necessary is an appropriate treatment”
Laparoscopic bile duct exploration is not a widely accepted technique and there
countries "in favor" and countries "against" at this point in time. Worldwide
acceptance is unlikely. Intraoperative cholangiography is more widely accepted
but still controversial, even in patients with relatively high risk of common bile
duct stones as most stones will pass spontaneously. Please revise these
paragraphs, using international guidelines +/- meta-analysis/reviews as
references.
- there is a difference in mortality between groups 1-2 and 3-4, please discuss
this difference. Is there another source of bias here, in the sense that the older
the patient, the more restrictive the surgical approach?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Please review this paper.
user
Reviewer's report
Title:Cholecystectomy and sphincterotomy in patients with mild acute biliary
pancreatitis in Sweden 1988 - 2003: a nationwide register study
Version: 1Date:4 December 2008
Reviewer: Hein Gooszen
Reviewer's report:
This is a review of the paper “Cholecystectomy and sphincterotomy in patients
with mild acute biliary pancreatitis in Sweden 1988 – 2003: a nationwide register
study” bij
Birger Sandzén et al.
Minor Essential Revisions (such as missing labels on figures, or the wrong use of
a term, which the author can be trusted to correct)
Introduction: “In UK guidelines” should be “In the UK guidelines”
Introduction: “Data from nationwide hospital discharge and death certificate
register were used” shoud read “Data from the nationwide….”
Results: 4 groups are described first here, please already describe them in the
methods section .
Results: please do not mention data with groups 1-4 in the text but rather use
tables.
Please ask a native speaker to check the full text of this paper. At numerous
points in the text words like “the” and “a” are missing
Major Compulsory Revisions
- Introduction:“The complication risk in predicted severe acute biliary pancreatitis,
but not in mild acute biliary pancreatitis (MABP), is reduced by early ERCP with
or without sphincterotomy [5]”. This statement is too strong according to recent
literature, such as Petrov et al, Ann Surg 2008.
- Explain how patients were divided into the four groups: institution policy,
docotor's preference, author's discretion?
- Discussion:
- explain potential biases, like in the subdivision into four groups, were age and
local preference and patient selection for the different approaches may hqave
played a major role by the type of treatment for the specific clinical and
radiological presentation; selection bias and its impact must be discussed here.
- “Thus, for patients with mild gallstone pancreatitis fit for surgery,
cholecystectomy at first admission, with intraoperative cholangiography and
concomitant bile duct exploration if necessary is an appropriate treatment”
Laparoscopic bile duct exploration is not a widely accepted technique and there
countries "in favor" and countries "against" at this point in time. Worldwide
acceptance is unlikely. Intraoperative cholangiography is more widely accepted
but still controversial, even in patients with relatively high risk of common bile
duct stones as most stones will pass spontaneously. Please revise these
paragraphs, using international guidelines +/- meta-analysis/reviews as
references.
- there is a difference in mortality between groups 1-2 and 3-4, please discuss
this difference. Is there another source of bias here, in the sense that the older
the patient, the more restrictive the surgical approach?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
assistant