Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  15 November 2006 Version: Date: 
 Angelo Andriulli Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
It is of relevance this topic being subjected to a meta-analysis from our oriental colleagues, as Gabexate is currently in use for the prophylaxis of post-ERCP pancreatitis in those countries. The negative results presented in the manuscript might contribute to a change in guidelines for the use of the drug. 
However, there are two substantial points to be addressed: 
- a thorough revision of English language, as some sentences are confusing or difficult to the immediate comprehension. 
- A relevant trial, although published in an Abstract form and therefore not yet available through Medline, is 
the one recently presented by Benvenuti and co-workers to the last meeting of the Italian Digestive week 
(Benvenuti S, Zancanella L, Piazzi L, Comberlato M, Chilovi F, Germanà B, Lecis P, Brosolo P, Ederle A. Prevention of post-ERCP pancreatitis with somatostatin versus gabexate mesilate: a randomized 
placebo-controlled multicenter study. Dig Liv Dis 2006;38:S15). This work needs to be included in the 
present meta-analysis because it adds clarity to a point addressed into the Authors’ Discussion section. In this trial Gabexate has been infused for longer than 12 hours and still negative results were achieved. These negative data are at odds with than Authors comment that “infusion over a longer period of time (12 
hours) of gabexate had been shown to be beneficial in trials that included all patients scheduled to undergo 
ERCP (page 10, line 8). 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. However, I have to make clear to have on publication a 
manuscript of mine dealing with some part of the topic of the work I've been asked to review. 
Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  15 November 2006 Version: Date: 
 Angelo Andriulli Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
It is of relevance this topic being subjected to a meta-analysis from our oriental colleagues, as Gabexate is currently in use for the prophylaxis of post-ERCP pancreatitis in those countries. The negative results presented in the manuscript might contribute to a change in guidelines for the use of the drug. 
However, there are two substantial points to be addressed: 
- a thorough revision of English language, as some sentences are confusing or difficult to the immediate comprehension. 
- A relevant trial, although published in an Abstract form and therefore not yet available through Medline, is 
the one recently presented by Benvenuti and co-workers to the last meeting of the Italian Digestive week 
(Benvenuti S, Zancanella L, Piazzi L, Comberlato M, Chilovi F, Germanà B, Lecis P, Brosolo P, Ederle A. Prevention of post-ERCP pancreatitis with somatostatin versus gabexate mesilate: a randomized 
placebo-controlled multicenter study. Dig Liv Dis 2006;38:S15). This work needs to be included in the 
present meta-analysis because it adds clarity to a point addressed into the Authors’ Discussion section. In this trial Gabexate has been infused for longer than 12 hours and still negative results were achieved. These negative data are at odds with than Authors comment that “infusion over a longer period of time (12 
hours) of gabexate had been shown to be beneficial in trials that included all patients scheduled to undergo 
ERCP (page 10, line 8). 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. However, I have to make clear to have on publication a 
manuscript of mine dealing with some part of the topic of the work I've been asked to review. 
Please review this paper.
user
Reviewer's report 
 Gabexate in the prophylaxis of post-ERCP pancreatitis: A meta-analysis of randomized controlled Title: 
trials 
 1  15 November 2006 Version: Date: 
 Angelo Andriulli Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
It is of relevance this topic being subjected to a meta-analysis from our oriental colleagues, as Gabexate is currently in use for the prophylaxis of post-ERCP pancreatitis in those countries. The negative results presented in the manuscript might contribute to a change in guidelines for the use of the drug. 
However, there are two substantial points to be addressed: 
- a thorough revision of English language, as some sentences are confusing or difficult to the immediate comprehension. 
- A relevant trial, although published in an Abstract form and therefore not yet available through Medline, is 
the one recently presented by Benvenuti and co-workers to the last meeting of the Italian Digestive week 
(Benvenuti S, Zancanella L, Piazzi L, Comberlato M, Chilovi F, Germanà B, Lecis P, Brosolo P, Ederle A. Prevention of post-ERCP pancreatitis with somatostatin versus gabexate mesilate: a randomized 
placebo-controlled multicenter study. Dig Liv Dis 2006;38:S15). This work needs to be included in the 
present meta-analysis because it adds clarity to a point addressed into the Authors’ Discussion section. In this trial Gabexate has been infused for longer than 12 hours and still negative results were achieved. These negative data are at odds with than Authors comment that “infusion over a longer period of time (12 
hours) of gabexate had been shown to be beneficial in trials that included all patients scheduled to undergo 
ERCP (page 10, line 8). 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 Yes Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. However, I have to make clear to have on publication a 
manuscript of mine dealing with some part of the topic of the work I've been asked to review. 
assistant