Title: Meta-analysis of the Effectiveness of Early Endoscopic Treatment of Acute Biliary
Pancreatitis based on Lightweight Deep Learning Model
Version: 1 Date: 27 Mar 2024
Reviewer's report:
The authors evaluated the clinical outcomes of early ERCP for ABP comparing with delayed
ERCP. The methods for extracting data and articles were described in great detail. And the
result showed that no remarkable differences were detected in mortality, the incidence of
complications, and operation time between early and delayed groups, while hospitalization
duration in the early group was notably shorter than that in the delayed group.
This is a well written, interesting paper, and useful contributing to clinical practice.
However, I would like to suggest some issues with several comments and criticisms as follows;
Comment 1:
The biggest concern with early ERCP for ABP is exacerbation of pancreatitis. However, the
procedure-related adverse events of ERCP in the both group were not investigated in this
manuscript. The authors needs to clarify this point.
Comment 2:
There are various treatments for therapeutic ERCP for ABP, such as papillary procedure, biliary
drainage, and pancreatic drainage.
The authors needs to explain what procedure is desirable in early ERCP for ABP and provide
supporting literatures.
Comment 3:
Discussion session: Page 22, line 352
“Some recent research show that delayed ERCP increases the incidence of recurrent biliary
events versus early ERCP, such as recurrent pancreatitis, cholecystitis, and biliary colic.” Please
refer to the literatures and add the reason for this.
Comment 4:
Results session: Page 21, line 325
As the author presents, the most common causes of ABP are cholecystolithiasis and bile
duct stones. In daily clinical practice, when the presence of stones is uncertain, EUS is often
performed to omit unnecessary ERCP and result in a favorable clinical course.
In these cases, early ERCP is unnecessary, so this point also needs to be discussed with reference
to the literatures.
Title: Meta-analysis of the Effectiveness of Early Endoscopic Treatment of Acute Biliary
Pancreatitis based on Lightweight Deep Learning Model
Version: 1 Date: 27 Mar 2024
Reviewer's report:
The authors evaluated the clinical outcomes of early ERCP for ABP comparing with delayed
ERCP. The methods for extracting data and articles were described in great detail. And the
result showed that no remarkable differences were detected in mortality, the incidence of
complications, and operation time between early and delayed groups, while hospitalization
duration in the early group was notably shorter than that in the delayed group.
This is a well written, interesting paper, and useful contributing to clinical practice.
However, I would like to suggest some issues with several comments and criticisms as follows;
Comment 1:
The biggest concern with early ERCP for ABP is exacerbation of pancreatitis. However, the
procedure-related adverse events of ERCP in the both group were not investigated in this
manuscript. The authors needs to clarify this point.
Comment 2:
There are various treatments for therapeutic ERCP for ABP, such as papillary procedure, biliary
drainage, and pancreatic drainage.
The authors needs to explain what procedure is desirable in early ERCP for ABP and provide
supporting literatures.
Comment 3:
Discussion session: Page 22, line 352
“Some recent research show that delayed ERCP increases the incidence of recurrent biliary
events versus early ERCP, such as recurrent pancreatitis, cholecystitis, and biliary colic.” Please
refer to the literatures and add the reason for this.
Comment 4:
Results session: Page 21, line 325
As the author presents, the most common causes of ABP are cholecystolithiasis and bile
duct stones. In daily clinical practice, when the presence of stones is uncertain, EUS is often
performed to omit unnecessary ERCP and result in a favorable clinical course.
In these cases, early ERCP is unnecessary, so this point also needs to be discussed with reference
to the literatures.
Please review this paper.
user
Title: Meta-analysis of the Effectiveness of Early Endoscopic Treatment of Acute Biliary
Pancreatitis based on Lightweight Deep Learning Model
Version: 1 Date: 27 Mar 2024
Reviewer's report:
The authors evaluated the clinical outcomes of early ERCP for ABP comparing with delayed
ERCP. The methods for extracting data and articles were described in great detail. And the
result showed that no remarkable differences were detected in mortality, the incidence of
complications, and operation time between early and delayed groups, while hospitalization
duration in the early group was notably shorter than that in the delayed group.
This is a well written, interesting paper, and useful contributing to clinical practice.
However, I would like to suggest some issues with several comments and criticisms as follows;
Comment 1:
The biggest concern with early ERCP for ABP is exacerbation of pancreatitis. However, the
procedure-related adverse events of ERCP in the both group were not investigated in this
manuscript. The authors needs to clarify this point.
Comment 2:
There are various treatments for therapeutic ERCP for ABP, such as papillary procedure, biliary
drainage, and pancreatic drainage.
The authors needs to explain what procedure is desirable in early ERCP for ABP and provide
supporting literatures.
Comment 3:
Discussion session: Page 22, line 352
“Some recent research show that delayed ERCP increases the incidence of recurrent biliary
events versus early ERCP, such as recurrent pancreatitis, cholecystitis, and biliary colic.” Please
refer to the literatures and add the reason for this.
Comment 4:
Results session: Page 21, line 325
As the author presents, the most common causes of ABP are cholecystolithiasis and bile
duct stones. In daily clinical practice, when the presence of stones is uncertain, EUS is often
performed to omit unnecessary ERCP and result in a favorable clinical course.
In these cases, early ERCP is unnecessary, so this point also needs to be discussed with reference
to the literatures.
assistant