Reviewer ’s report  
 
Title: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 1 Date: 06 Apr 2020  
 
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
The present study relates the role of FCSEMS in patients with biliary anastomotic strictures 
post liver transplant  
-Add biliary to the title and to key words  
-The abstract is very short  
-I think that it could be interesting to know how many patients were t ransplanted during the 
same period. What is the frequency of biliary AS in your center ?  
-Frequency of Early (less than one month or 3 months) and late (more than one or three 
months) biliary anastomosis ?  
-How the diagnosis was done ? How do you define st enosis ? Sometimes it is difficult to 
distinguish narrowing from stenosis  
-Do you use biliary MRI ?  
-How many patients had intrahepatic biliary dilation at ultrasound ?  
-How many were associated with bile leak ? bilioma ?  
-Do you realize dilation before s tenting ?  
-You should discuss the benefits and inconvenients of MPS (multiple plastic stents) vs 
metallic stents  
-It looks like the cost of metallic stents is lower than MPS (see Endoscopy International)  
-Is there a benefit of Kaffe stents as compared to o ther metallic stents  
-How to you define treatment efficacy ? You use a baloon ? what size of biliary diameter is 
sufficient after three months of stenting ?  
-How do you define treatment failure ?  
-The references are very old and should be changed. I sugges t three recent references  
1) Dong Wook Lee et al. Clinical Endoscopy 2016  
2) Thiago Arantes de Carvalho Visconti et al. Endoscopy International Open 2018  
3) Cantu Paolo et al. Digestive Liver Disease 2016  
-Is there any conflict of interest between you and  the korean company ? do they give to you 
the stents for free ?  
 
 
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.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, 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 fro m 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 journ al. 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 m y 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: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 1 Date: 06 Apr 2020  
 
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
The present study relates the role of FCSEMS in patients with biliary anastomotic strictures 
post liver transplant  
-Add biliary to the title and to key words  
-The abstract is very short  
-I think that it could be interesting to know how many patients were t ransplanted during the 
same period. What is the frequency of biliary AS in your center ?  
-Frequency of Early (less than one month or 3 months) and late (more than one or three 
months) biliary anastomosis ?  
-How the diagnosis was done ? How do you define st enosis ? Sometimes it is difficult to 
distinguish narrowing from stenosis  
-Do you use biliary MRI ?  
-How many patients had intrahepatic biliary dilation at ultrasound ?  
-How many were associated with bile leak ? bilioma ?  
-Do you realize dilation before s tenting ?  
-You should discuss the benefits and inconvenients of MPS (multiple plastic stents) vs 
metallic stents  
-It looks like the cost of metallic stents is lower than MPS (see Endoscopy International)  
-Is there a benefit of Kaffe stents as compared to o ther metallic stents  
-How to you define treatment efficacy ? You use a baloon ? what size of biliary diameter is 
sufficient after three months of stenting ?  
-How do you define treatment failure ?  
-The references are very old and should be changed. I sugges t three recent references  
1) Dong Wook Lee et al. Clinical Endoscopy 2016  
2) Thiago Arantes de Carvalho Visconti et al. Endoscopy International Open 2018  
3) Cantu Paolo et al. Digestive Liver Disease 2016  
-Is there any conflict of interest between you and  the korean company ? do they give to you 
the stents for free ?  
 
 
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.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, 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 fro m 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 journ al. 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 m y 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: A unique type of fully covered metal s tent for the management of post liver transplant  
biliary anastomotic strictures  
 
Version: 1 Date: 06 Apr 2020  
 
Reviewer: Armand Abergel  
 
Reviewer's report:  
 
The present study relates the role of FCSEMS in patients with biliary anastomotic strictures 
post liver transplant  
-Add biliary to the title and to key words  
-The abstract is very short  
-I think that it could be interesting to know how many patients were t ransplanted during the 
same period. What is the frequency of biliary AS in your center ?  
-Frequency of Early (less than one month or 3 months) and late (more than one or three 
months) biliary anastomosis ?  
-How the diagnosis was done ? How do you define st enosis ? Sometimes it is difficult to 
distinguish narrowing from stenosis  
-Do you use biliary MRI ?  
-How many patients had intrahepatic biliary dilation at ultrasound ?  
-How many were associated with bile leak ? bilioma ?  
-Do you realize dilation before s tenting ?  
-You should discuss the benefits and inconvenients of MPS (multiple plastic stents) vs 
metallic stents  
-It looks like the cost of metallic stents is lower than MPS (see Endoscopy International)  
-Is there a benefit of Kaffe stents as compared to o ther metallic stents  
-How to you define treatment efficacy ? You use a baloon ? what size of biliary diameter is 
sufficient after three months of stenting ?  
-How do you define treatment failure ?  
-The references are very old and should be changed. I sugges t three recent references  
1) Dong Wook Lee et al. Clinical Endoscopy 2016  
2) Thiago Arantes de Carvalho Visconti et al. Endoscopy International Open 2018  
3) Cantu Paolo et al. Digestive Liver Disease 2016  
-Is there any conflict of interest between you and  the korean company ? do they give to you 
the stents for free ?  
 
 
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.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, 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 fro m 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 journ al. 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 m y 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