Title: The longterm impact of post-cholecystectomy major bile duct injury on liver stiffness.
Version: 5 Date: 21 Sep 2024
Reviewer's report:
1. It is an important study, Well done!
2. Hepatic fibrosis is known complication after severe bile duct injuries
3. Fibroscan looked at the right lobe following RHA injury,  Fibrosis is expected as mentioned
by the author- how would this have made a difference in the outcome ? Were the Liver functions
severely compromised after 6 months ?
3. please include the no of patients who underwent HJ in the table
4. 16 patients were offered HJ ? did they undergo the procedure? Please correct this
5. total patients with anastomotic stricture were (6+3) 9 and without anastomotic stricture were
(9+1) 10 , that makes it 19 patients , while the surgery was offered to 16 patients, could you
clarify this please.
6. Was there any other form of radiological imaging done around the time of fibroscan? Any
relevant or significant changes from the time of injury or pre operative studies.
7. Any endoscopic interventions attempted for BDI injuries ?
8. Were there any other complications other than cholangitis among these patients ? ( such as
abscess, necrosis)
9.   Conclusion - "Major BDI repair demonstrates comparable liver fibrosis between patients and
healthy controls. Measuring liver fibrosis could be valuable in the presence of arterial injuries
or anastomotic stricture" - could mean early HJ in all major BDIs provides comparable  liver
fibrosis to controls- please clarify, and how is it valuable  with a known cause and effect ?
Title: The longterm impact of post-cholecystectomy major bile duct injury on liver stiffness.
Version: 5 Date: 21 Sep 2024
Reviewer's report:
1. It is an important study, Well done!
2. Hepatic fibrosis is known complication after severe bile duct injuries
3. Fibroscan looked at the right lobe following RHA injury,  Fibrosis is expected as mentioned
by the author- how would this have made a difference in the outcome ? Were the Liver functions
severely compromised after 6 months ?
3. please include the no of patients who underwent HJ in the table
4. 16 patients were offered HJ ? did they undergo the procedure? Please correct this
5. total patients with anastomotic stricture were (6+3) 9 and without anastomotic stricture were
(9+1) 10 , that makes it 19 patients , while the surgery was offered to 16 patients, could you
clarify this please.
6. Was there any other form of radiological imaging done around the time of fibroscan? Any
relevant or significant changes from the time of injury or pre operative studies.
7. Any endoscopic interventions attempted for BDI injuries ?
8. Were there any other complications other than cholangitis among these patients ? ( such as
abscess, necrosis)
9.   Conclusion - "Major BDI repair demonstrates comparable liver fibrosis between patients and
healthy controls. Measuring liver fibrosis could be valuable in the presence of arterial injuries
or anastomotic stricture" - could mean early HJ in all major BDIs provides comparable  liver
fibrosis to controls- please clarify, and how is it valuable  with a known cause and effect ?
Please review this paper.
user
Title: The longterm impact of post-cholecystectomy major bile duct injury on liver stiffness.
Version: 5 Date: 21 Sep 2024
Reviewer's report:
1. It is an important study, Well done!
2. Hepatic fibrosis is known complication after severe bile duct injuries
3. Fibroscan looked at the right lobe following RHA injury,  Fibrosis is expected as mentioned
by the author- how would this have made a difference in the outcome ? Were the Liver functions
severely compromised after 6 months ?
3. please include the no of patients who underwent HJ in the table
4. 16 patients were offered HJ ? did they undergo the procedure? Please correct this
5. total patients with anastomotic stricture were (6+3) 9 and without anastomotic stricture were
(9+1) 10 , that makes it 19 patients , while the surgery was offered to 16 patients, could you
clarify this please.
6. Was there any other form of radiological imaging done around the time of fibroscan? Any
relevant or significant changes from the time of injury or pre operative studies.
7. Any endoscopic interventions attempted for BDI injuries ?
8. Were there any other complications other than cholangitis among these patients ? ( such as
abscess, necrosis)
9.   Conclusion - "Major BDI repair demonstrates comparable liver fibrosis between patients and
healthy controls. Measuring liver fibrosis could be valuable in the presence of arterial injuries
or anastomotic stricture" - could mean early HJ in all major BDIs provides comparable  liver
fibrosis to controls- please clarify, and how is it valuable  with a known cause and effect ?
assistant