Reviewer’s report
Title: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 0 Date: 13 May 2018
Reviewer: Abhishek Agnihotri
Reviewer's report:
The authors in this retrospective study have tried to shed light on essentially the extraintestinal GI  
manifestations of IBD. It is important to identify patterns of extraintestinal manifestations and other  
organ involvement of the GI tract. However, the study fails to add meaningfully to the literature on IBD  
at present.
1) The methodology is weak, given this is a retrospective study, it is not possible to find out the  
prevalence of other GI organ involvement, especially in setting of imaging modalities available  
for review in less than half of the cases. The methods need to be defined more clearly. A clear  
description of diagnostic process is needed. Is there a protocol in place on imaging and testing  
in IBD at the center? etc.
2) The imaging modalities are available only in a select few, thus the results are heavily skewed.  
Was  imaging  done  in  patients  with  more  severe  disease?  This  should  be  discussed  as  
limitations.
3) It would not be appropriate to compare the incidences of other manifestations, such as PSC, with  
other studies with different methodology.
4) It is difficult to identify results which are going to add meaningfully to the already available data.
5) One way this study could be written differently would be to compare it with other studies from  
Greece, to compare differences in extra intestinal findings and trying to identify patterns to  
better characterize risks in various patient populations.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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  financially  from  the  publication  of  this  
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose financially  
from the publication 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: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 0 Date: 13 May 2018
Reviewer: Abhishek Agnihotri
Reviewer's report:
The authors in this retrospective study have tried to shed light on essentially the extraintestinal GI  
manifestations of IBD. It is important to identify patterns of extraintestinal manifestations and other  
organ involvement of the GI tract. However, the study fails to add meaningfully to the literature on IBD  
at present.
1) The methodology is weak, given this is a retrospective study, it is not possible to find out the  
prevalence of other GI organ involvement, especially in setting of imaging modalities available  
for review in less than half of the cases. The methods need to be defined more clearly. A clear  
description of diagnostic process is needed. Is there a protocol in place on imaging and testing  
in IBD at the center? etc.
2) The imaging modalities are available only in a select few, thus the results are heavily skewed.  
Was  imaging  done  in  patients  with  more  severe  disease?  This  should  be  discussed  as  
limitations.
3) It would not be appropriate to compare the incidences of other manifestations, such as PSC, with  
other studies with different methodology.
4) It is difficult to identify results which are going to add meaningfully to the already available data.
5) One way this study could be written differently would be to compare it with other studies from  
Greece, to compare differences in extra intestinal findings and trying to identify patterns to  
better characterize risks in various patient populations.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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  financially  from  the  publication  of  this  
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose financially  
from the publication 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: Hepatobiliary and Pancreatic Manifestations in Inflammatory Bowel Diseases: A Referral Center  
Study
Version: 0 Date: 13 May 2018
Reviewer: Abhishek Agnihotri
Reviewer's report:
The authors in this retrospective study have tried to shed light on essentially the extraintestinal GI  
manifestations of IBD. It is important to identify patterns of extraintestinal manifestations and other  
organ involvement of the GI tract. However, the study fails to add meaningfully to the literature on IBD  
at present.
1) The methodology is weak, given this is a retrospective study, it is not possible to find out the  
prevalence of other GI organ involvement, especially in setting of imaging modalities available  
for review in less than half of the cases. The methods need to be defined more clearly. A clear  
description of diagnostic process is needed. Is there a protocol in place on imaging and testing  
in IBD at the center? etc.
2) The imaging modalities are available only in a select few, thus the results are heavily skewed.  
Was  imaging  done  in  patients  with  more  severe  disease?  This  should  be  discussed  as  
limitations.
3) It would not be appropriate to compare the incidences of other manifestations, such as PSC, with  
other studies with different methodology.
4) It is difficult to identify results which are going to add meaningfully to the already available data.
5) One way this study could be written differently would be to compare it with other studies from  
Greece, to compare differences in extra intestinal findings and trying to identify patterns to  
better characterize risks in various patient populations.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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  financially  from  the  publication  of  this  
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose financially  
from the publication 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