Title: Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute
purulent cholecystitis
Version: 4 Date: 19 Jul 2022
Reviewer's report:
Thank you for the opportunity to review the manuscript. The authors investigated the clinical
indexes to distinguish acute severe cholecystitis from chronic cholecystitis. It is important to
diagnose severe cholecystitis quickly and accurately for the treatment.
Major concerns:
1. It is not clear why the authors compared acute severe cholecystitis to chronic cholecystitis.
(It is easy to distinguish “acute severe” cholecystitis from “chronic” cholecystitis without novel
indexes.)
2. The definition of severe cholecystitis is ambiguous. (i.e. Are there any other acute cholecystitis
patients with moderate inflammation during the study period?)
3. Classifications of cholecystitis (AGC, GA, APC) are not generally used.
4. Because this study focused on the prediction of “severe” cholecystitis, elective surgery should
be excluded.
Minor concerns:
1. This study investigated clinical indexes to predict severe cholecystitis by comparing it to
“chronic cholecystitis”. The study title should be modified.
2. Treatment strategies for acute cholecystitis (emergency/delayed cholecystectomy,
percutaneous drainage, etc.) in authors’ institution should be briefly mentioned.
3. The reasons of mortality should be mentioned.
4. Perioperative outcomes (surgical characteristics, ICU stay, hospital stay, etc.) are
recommended to be shown in Supplemental data.
5. Table legends are not correct. “underwent cholecystitis” should be “underwent
cholecystectomy”.
6. Some cited references do not match the sentences ([5], [15], [16]).
In Discussion, reference [5] was cited, “the mortality rate of SC in much higher than that
of chronic cholecystitis (CC) [5]”. However, the study of reference [5] excluded chronic
cholecystitis.
Title: Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute
purulent cholecystitis
Version: 4 Date: 19 Jul 2022
Reviewer's report:
Thank you for the opportunity to review the manuscript. The authors investigated the clinical
indexes to distinguish acute severe cholecystitis from chronic cholecystitis. It is important to
diagnose severe cholecystitis quickly and accurately for the treatment.
Major concerns:
1. It is not clear why the authors compared acute severe cholecystitis to chronic cholecystitis.
(It is easy to distinguish “acute severe” cholecystitis from “chronic” cholecystitis without novel
indexes.)
2. The definition of severe cholecystitis is ambiguous. (i.e. Are there any other acute cholecystitis
patients with moderate inflammation during the study period?)
3. Classifications of cholecystitis (AGC, GA, APC) are not generally used.
4. Because this study focused on the prediction of “severe” cholecystitis, elective surgery should
be excluded.
Minor concerns:
1. This study investigated clinical indexes to predict severe cholecystitis by comparing it to
“chronic cholecystitis”. The study title should be modified.
2. Treatment strategies for acute cholecystitis (emergency/delayed cholecystectomy,
percutaneous drainage, etc.) in authors’ institution should be briefly mentioned.
3. The reasons of mortality should be mentioned.
4. Perioperative outcomes (surgical characteristics, ICU stay, hospital stay, etc.) are
recommended to be shown in Supplemental data.
5. Table legends are not correct. “underwent cholecystitis” should be “underwent
cholecystectomy”.
6. Some cited references do not match the sentences ([5], [15], [16]).
In Discussion, reference [5] was cited, “the mortality rate of SC in much higher than that
of chronic cholecystitis (CC) [5]”. However, the study of reference [5] excluded chronic
cholecystitis.
Please review this paper.
user
Title: Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute
purulent cholecystitis
Version: 4 Date: 19 Jul 2022
Reviewer's report:
Thank you for the opportunity to review the manuscript. The authors investigated the clinical
indexes to distinguish acute severe cholecystitis from chronic cholecystitis. It is important to
diagnose severe cholecystitis quickly and accurately for the treatment.
Major concerns:
1. It is not clear why the authors compared acute severe cholecystitis to chronic cholecystitis.
(It is easy to distinguish “acute severe” cholecystitis from “chronic” cholecystitis without novel
indexes.)
2. The definition of severe cholecystitis is ambiguous. (i.e. Are there any other acute cholecystitis
patients with moderate inflammation during the study period?)
3. Classifications of cholecystitis (AGC, GA, APC) are not generally used.
4. Because this study focused on the prediction of “severe” cholecystitis, elective surgery should
be excluded.
Minor concerns:
1. This study investigated clinical indexes to predict severe cholecystitis by comparing it to
“chronic cholecystitis”. The study title should be modified.
2. Treatment strategies for acute cholecystitis (emergency/delayed cholecystectomy,
percutaneous drainage, etc.) in authors’ institution should be briefly mentioned.
3. The reasons of mortality should be mentioned.
4. Perioperative outcomes (surgical characteristics, ICU stay, hospital stay, etc.) are
recommended to be shown in Supplemental data.
5. Table legends are not correct. “underwent cholecystitis” should be “underwent
cholecystectomy”.
6. Some cited references do not match the sentences ([5], [15], [16]).
In Discussion, reference [5] was cited, “the mortality rate of SC in much higher than that
of chronic cholecystitis (CC) [5]”. However, the study of reference [5] excluded chronic
cholecystitis.
assistant