Title: Diagnostic value of T-tube cholangiography and choledochoscopy in residual calculi after
biliary surgery
Version: 2 Date: 04 Jun 2024
Reviewer:  Ahmad M. Sultan
Reviewer's report:
the topic is not widely available for researchers, the idea is promising, however there are some
comments;
Major comments:
1 - The abstract is not clear, needed to read it multiple times
2- as regards the METHODS section:
-1  surgery approaches sub title is confusing - better changed to procedure approaches
-2  the timing of the procedure is not specified clearly to be after 6-8 weeks of the index surgery
-3 was these patients discharged and come back on a scheduled date ?
-4 was the t-tube closed prior to discharge ? and on follow up how many cases showed symptoms
or laboratory abnormalities because of the retained stones? or those patients were excluded?
( you mentioned incarcerated stones )
-5 what was the interval between T tube and subsequent choledochoscopy?
-7 were all cases successful for choledochoscopic extraction? was there any incomplete
procedures
3- the RESULTS section:
-1 table 1 shows previous LC, what does it refer to?
-2 the false negative rate for TTC was found to be 11 cases out of 249 case , as I understand
from table 2 ,  this is not 27.5% . please revise.
-3 the paragraph describing the choledochscopy is not clear and needs rewriting.
-4 there is no description of the management following failed cholechocoscopic extraction (CE)
-5 with the results of no significant difference between the 2 methods, I would like your comment
on the cost, the quality of life of these patients.
4-the Discussion section:
-1 too long
-2 did not discuss your causes of false positive TTC aside from 3 cases with bubbles
-3 the paragraph on 242 is irrelevant to the study design. however, the bile turbidity reported in
this series may point to the prolonged placement of the T tube and its possible complications.
-4 with the results of no significant difference between the 2 methods, I would like you to
comment on the quality of life of these patients. as usually, T tube cholangiogram can be
performed after 2 weeks, if negative it is removed  and if positive we arrange for ERCP
extraction. this ends the patients' problems earlier than the proposed and recommended tech.
5-the CONCLUSION
I think the conclusion is far from the results. adding choledoscopy did not prove statistically
significant difference. It provides advantages as mentioned.
please revise the false negative rate of TTC.
minor comments:
- using angiography instead of cholangiography, needs attention
- line 204 comment on b, needs revision
Title: Diagnostic value of T-tube cholangiography and choledochoscopy in residual calculi after
biliary surgery
Version: 2 Date: 04 Jun 2024
Reviewer:  Ahmad M. Sultan
Reviewer's report:
the topic is not widely available for researchers, the idea is promising, however there are some
comments;
Major comments:
1 - The abstract is not clear, needed to read it multiple times
2- as regards the METHODS section:
-1  surgery approaches sub title is confusing - better changed to procedure approaches
-2  the timing of the procedure is not specified clearly to be after 6-8 weeks of the index surgery
-3 was these patients discharged and come back on a scheduled date ?
-4 was the t-tube closed prior to discharge ? and on follow up how many cases showed symptoms
or laboratory abnormalities because of the retained stones? or those patients were excluded?
( you mentioned incarcerated stones )
-5 what was the interval between T tube and subsequent choledochoscopy?
-7 were all cases successful for choledochoscopic extraction? was there any incomplete
procedures
3- the RESULTS section:
-1 table 1 shows previous LC, what does it refer to?
-2 the false negative rate for TTC was found to be 11 cases out of 249 case , as I understand
from table 2 ,  this is not 27.5% . please revise.
-3 the paragraph describing the choledochscopy is not clear and needs rewriting.
-4 there is no description of the management following failed cholechocoscopic extraction (CE)
-5 with the results of no significant difference between the 2 methods, I would like your comment
on the cost, the quality of life of these patients.
4-the Discussion section:
-1 too long
-2 did not discuss your causes of false positive TTC aside from 3 cases with bubbles
-3 the paragraph on 242 is irrelevant to the study design. however, the bile turbidity reported in
this series may point to the prolonged placement of the T tube and its possible complications.
-4 with the results of no significant difference between the 2 methods, I would like you to
comment on the quality of life of these patients. as usually, T tube cholangiogram can be
performed after 2 weeks, if negative it is removed  and if positive we arrange for ERCP
extraction. this ends the patients' problems earlier than the proposed and recommended tech.
5-the CONCLUSION
I think the conclusion is far from the results. adding choledoscopy did not prove statistically
significant difference. It provides advantages as mentioned.
please revise the false negative rate of TTC.
minor comments:
- using angiography instead of cholangiography, needs attention
- line 204 comment on b, needs revision
Please review this paper.
user
Title: Diagnostic value of T-tube cholangiography and choledochoscopy in residual calculi after
biliary surgery
Version: 2 Date: 04 Jun 2024
Reviewer:  Ahmad M. Sultan
Reviewer's report:
the topic is not widely available for researchers, the idea is promising, however there are some
comments;
Major comments:
1 - The abstract is not clear, needed to read it multiple times
2- as regards the METHODS section:
-1  surgery approaches sub title is confusing - better changed to procedure approaches
-2  the timing of the procedure is not specified clearly to be after 6-8 weeks of the index surgery
-3 was these patients discharged and come back on a scheduled date ?
-4 was the t-tube closed prior to discharge ? and on follow up how many cases showed symptoms
or laboratory abnormalities because of the retained stones? or those patients were excluded?
( you mentioned incarcerated stones )
-5 what was the interval between T tube and subsequent choledochoscopy?
-7 were all cases successful for choledochoscopic extraction? was there any incomplete
procedures
3- the RESULTS section:
-1 table 1 shows previous LC, what does it refer to?
-2 the false negative rate for TTC was found to be 11 cases out of 249 case , as I understand
from table 2 ,  this is not 27.5% . please revise.
-3 the paragraph describing the choledochscopy is not clear and needs rewriting.
-4 there is no description of the management following failed cholechocoscopic extraction (CE)
-5 with the results of no significant difference between the 2 methods, I would like your comment
on the cost, the quality of life of these patients.
4-the Discussion section:
-1 too long
-2 did not discuss your causes of false positive TTC aside from 3 cases with bubbles
-3 the paragraph on 242 is irrelevant to the study design. however, the bile turbidity reported in
this series may point to the prolonged placement of the T tube and its possible complications.
-4 with the results of no significant difference between the 2 methods, I would like you to
comment on the quality of life of these patients. as usually, T tube cholangiogram can be
performed after 2 weeks, if negative it is removed  and if positive we arrange for ERCP
extraction. this ends the patients' problems earlier than the proposed and recommended tech.
5-the CONCLUSION
I think the conclusion is far from the results. adding choledoscopy did not prove statistically
significant difference. It provides advantages as mentioned.
please revise the false negative rate of TTC.
minor comments:
- using angiography instead of cholangiography, needs attention
- line 204 comment on b, needs revision
assistant