Reviewer ’s report  
 
Title: Treatment of Post -Cholecystectomy Biliary Strictures wi th Fully -Covered Self -Expanding 
Metal Stents - Results after 5 years of Follow -up 
 
Version: 0 Date: 27 Aug 2019  
 
Reviewer: Mohan Ramchandani  
 
Reviewer's report:  
 
Authors have performed a multicentre prospe ctive study evaluating the role of Fully covered 
metal stents (FCSEMS) in cases of Benign biliary stricture. Subgroup analysis of patients with 
post cholecystectomy biliary stricture (n=18) was done with follow up of five years. This is 
important study to know the log term efficacy of FCSEMS in patients with post -operative benign 
biliary strictures.  
 
1. In result section authors have mentioned that "Endoscopic removal was performed at the 
planned  removal time in 11 patients, with median indwell duration of 11.5 months (range 10.4 -
13.8 months). Early uneventful endoscopic FCSEMS removal was prompted by cholangitis in 4 
patients  after median indwell duration of 3.8 months (range 0.9 -8.9 months)'.  
 
In discussion section . Page 12 line 20 - 'Endoscopic removal took place as planned after 10 -12 
month indwell in 14 patients, and early due to cholangitis in 4 patients'. The numbers need to be 
rechecked as planed endoscopic removal was done in 11 patients.  
 
 
2. Two patients in stricture resolution group had cholangitis and the FCSEMS was removed. 
What was the indwell time when these stents were removed and how these patients were 
managed further?  
 
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Yes 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re 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:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 curr ently 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
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 understan d that any comments 
which I do not wish to be included in my named report can be in cluded 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: Treatment of Post -Cholecystectomy Biliary Strictures wi th Fully -Covered Self -Expanding 
Metal Stents - Results after 5 years of Follow -up 
 
Version: 0 Date: 27 Aug 2019  
 
Reviewer: Mohan Ramchandani  
 
Reviewer's report:  
 
Authors have performed a multicentre prospe ctive study evaluating the role of Fully covered 
metal stents (FCSEMS) in cases of Benign biliary stricture. Subgroup analysis of patients with 
post cholecystectomy biliary stricture (n=18) was done with follow up of five years. This is 
important study to know the log term efficacy of FCSEMS in patients with post -operative benign 
biliary strictures.  
 
1. In result section authors have mentioned that "Endoscopic removal was performed at the 
planned  removal time in 11 patients, with median indwell duration of 11.5 months (range 10.4 -
13.8 months). Early uneventful endoscopic FCSEMS removal was prompted by cholangitis in 4 
patients  after median indwell duration of 3.8 months (range 0.9 -8.9 months)'.  
 
In discussion section . Page 12 line 20 - 'Endoscopic removal took place as planned after 10 -12 
month indwell in 14 patients, and early due to cholangitis in 4 patients'. The numbers need to be 
rechecked as planed endoscopic removal was done in 11 patients.  
 
 
2. Two patients in stricture resolution group had cholangitis and the FCSEMS was removed. 
What was the indwell time when these stents were removed and how these patients were 
managed further?  
 
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Yes 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re 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:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 curr ently 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
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 understan d that any comments 
which I do not wish to be included in my named report can be in cluded 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: Treatment of Post -Cholecystectomy Biliary Strictures wi th Fully -Covered Self -Expanding 
Metal Stents - Results after 5 years of Follow -up 
 
Version: 0 Date: 27 Aug 2019  
 
Reviewer: Mohan Ramchandani  
 
Reviewer's report:  
 
Authors have performed a multicentre prospe ctive study evaluating the role of Fully covered 
metal stents (FCSEMS) in cases of Benign biliary stricture. Subgroup analysis of patients with 
post cholecystectomy biliary stricture (n=18) was done with follow up of five years. This is 
important study to know the log term efficacy of FCSEMS in patients with post -operative benign 
biliary strictures.  
 
1. In result section authors have mentioned that "Endoscopic removal was performed at the 
planned  removal time in 11 patients, with median indwell duration of 11.5 months (range 10.4 -
13.8 months). Early uneventful endoscopic FCSEMS removal was prompted by cholangitis in 4 
patients  after median indwell duration of 3.8 months (range 0.9 -8.9 months)'.  
 
In discussion section . Page 12 line 20 - 'Endoscopic removal took place as planned after 10 -12 
month indwell in 14 patients, and early due to cholangitis in 4 patients'. The numbers need to be 
rechecked as planed endoscopic removal was done in 11 patients.  
 
 
2. Two patients in stricture resolution group had cholangitis and the FCSEMS was removed. 
What was the indwell time when these stents were removed and how these patients were 
managed further?  
 
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Yes 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re 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:  
 
Acceptable  
 
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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financially from the 
publi cation of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 curr ently 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repo rt 
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 understan d that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant