Title: Value of nonenhanced CT combined with laboratory examinations in the diagnosis of
acute suppurative cholecystitis treated with percutaneous cholecystostomy : A retrospective
study
Version: 3 Date: 07 Jan 2022
Reviewer's report:
Dear Editor,
I read with interest the manuscript by Bai-Qing Chen et al entitled “Value of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis: A
retrospective study”
The work deals with a relevant and trending topic considering the impact of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis. The
work was conducted with a good methodology and it carries some interesting results; however,
there are some points that I would like to stress.
Revision:
Introduction:
Page 2 line 21 :
“Currently, LC and percutaneous cholecystostomy (PC) are the main surgical methods for ASC
both of which can confirm ASC during surgery”
Percutaneous cholecystectomy is not a surgical method. It’s an alternative drainage method of
surgery in fragile patients.
Please modify.
The Authors reported the value of nonenhanced CT combined with laboratory examinations in
the diagnosis of acute suppurative cholecystitis. However the reasons for choosing this imaging
method have not been reported. It may be interesting for readers to specify why the authors
choose to perform a nonenhanced CT instead of an enhanced CT.
Please revise accordingly
Results:
Page 7 line 22:
The abbreviation of common bile duct (CBD) has already been mentioned above in the text.
Please insert CBD directly.
In the results the Authors reported that 204 patients are included in the study and are divided
in 2 groups.
However, in the text and in Table1 are reported 138 patients for Group 1 and 63 for Group 2
but the sum appears to be 201.
Please revise and modify text and Table1 accordingly.
Discussion.
Page 11 line 14
“PC is more widely performed than cholecystectomy”
This phrase could be misunderstood.
Laparosacopic cholecystectomy is the gold standard treatment for acute cholecystitis.
However, poor surgical candidates may benefit from gallbladder drainage.
PC is a useful and widely available gallbladder drainage method but it’s an alternative for high-
risk patients in whom urgent surgery is contraindicated, such as elderly, critically ill, or those
with severe comorbidities.
Plese revise this sentence accordingly.
Neverthless, PC-related adverse may occur in up to 25% of the patients.
As reported in two recent reviews on gallbladder drainage (PMID 32523368; PMID
32523368) there are two endoscopic GBD methods: the transmural approach guided by
endoscopic ultrasound (EUS), and endoscopic transpapillary gallbladder drainage (ETGBD)
under endoscopic retrograde cholangiopancreatography (ERCP).
Could be usefull for the readers to mention this alternative drainage methods in the manuscript.
Please comment this topic in the discussion including these reviews in the manuscript.
Title: Value of nonenhanced CT combined with laboratory examinations in the diagnosis of
acute suppurative cholecystitis treated with percutaneous cholecystostomy : A retrospective
study
Version: 3 Date: 07 Jan 2022
Reviewer's report:
Dear Editor,
I read with interest the manuscript by Bai-Qing Chen et al entitled “Value of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis: A
retrospective study”
The work deals with a relevant and trending topic considering the impact of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis. The
work was conducted with a good methodology and it carries some interesting results; however,
there are some points that I would like to stress.
Revision:
Introduction:
Page 2 line 21 :
“Currently, LC and percutaneous cholecystostomy (PC) are the main surgical methods for ASC
both of which can confirm ASC during surgery”
Percutaneous cholecystectomy is not a surgical method. It’s an alternative drainage method of
surgery in fragile patients.
Please modify.
The Authors reported the value of nonenhanced CT combined with laboratory examinations in
the diagnosis of acute suppurative cholecystitis. However the reasons for choosing this imaging
method have not been reported. It may be interesting for readers to specify why the authors
choose to perform a nonenhanced CT instead of an enhanced CT.
Please revise accordingly
Results:
Page 7 line 22:
The abbreviation of common bile duct (CBD) has already been mentioned above in the text.
Please insert CBD directly.
In the results the Authors reported that 204 patients are included in the study and are divided
in 2 groups.
However, in the text and in Table1 are reported 138 patients for Group 1 and 63 for Group 2
but the sum appears to be 201.
Please revise and modify text and Table1 accordingly.
Discussion.
Page 11 line 14
“PC is more widely performed than cholecystectomy”
This phrase could be misunderstood.
Laparosacopic cholecystectomy is the gold standard treatment for acute cholecystitis.
However, poor surgical candidates may benefit from gallbladder drainage.
PC is a useful and widely available gallbladder drainage method but it’s an alternative for high-
risk patients in whom urgent surgery is contraindicated, such as elderly, critically ill, or those
with severe comorbidities.
Plese revise this sentence accordingly.
Neverthless, PC-related adverse may occur in up to 25% of the patients.
As reported in two recent reviews on gallbladder drainage (PMID 32523368; PMID
32523368) there are two endoscopic GBD methods: the transmural approach guided by
endoscopic ultrasound (EUS), and endoscopic transpapillary gallbladder drainage (ETGBD)
under endoscopic retrograde cholangiopancreatography (ERCP).
Could be usefull for the readers to mention this alternative drainage methods in the manuscript.
Please comment this topic in the discussion including these reviews in the manuscript.
Please review this paper.
user
Title: Value of nonenhanced CT combined with laboratory examinations in the diagnosis of
acute suppurative cholecystitis treated with percutaneous cholecystostomy : A retrospective
study
Version: 3 Date: 07 Jan 2022
Reviewer's report:
Dear Editor,
I read with interest the manuscript by Bai-Qing Chen et al entitled “Value of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis: A
retrospective study”
The work deals with a relevant and trending topic considering the impact of nonenhanced CT
combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis. The
work was conducted with a good methodology and it carries some interesting results; however,
there are some points that I would like to stress.
Revision:
Introduction:
Page 2 line 21 :
“Currently, LC and percutaneous cholecystostomy (PC) are the main surgical methods for ASC
both of which can confirm ASC during surgery”
Percutaneous cholecystectomy is not a surgical method. It’s an alternative drainage method of
surgery in fragile patients.
Please modify.
The Authors reported the value of nonenhanced CT combined with laboratory examinations in
the diagnosis of acute suppurative cholecystitis. However the reasons for choosing this imaging
method have not been reported. It may be interesting for readers to specify why the authors
choose to perform a nonenhanced CT instead of an enhanced CT.
Please revise accordingly
Results:
Page 7 line 22:
The abbreviation of common bile duct (CBD) has already been mentioned above in the text.
Please insert CBD directly.
In the results the Authors reported that 204 patients are included in the study and are divided
in 2 groups.
However, in the text and in Table1 are reported 138 patients for Group 1 and 63 for Group 2
but the sum appears to be 201.
Please revise and modify text and Table1 accordingly.
Discussion.
Page 11 line 14
“PC is more widely performed than cholecystectomy”
This phrase could be misunderstood.
Laparosacopic cholecystectomy is the gold standard treatment for acute cholecystitis.
However, poor surgical candidates may benefit from gallbladder drainage.
PC is a useful and widely available gallbladder drainage method but it’s an alternative for high-
risk patients in whom urgent surgery is contraindicated, such as elderly, critically ill, or those
with severe comorbidities.
Plese revise this sentence accordingly.
Neverthless, PC-related adverse may occur in up to 25% of the patients.
As reported in two recent reviews on gallbladder drainage (PMID 32523368; PMID
32523368) there are two endoscopic GBD methods: the transmural approach guided by
endoscopic ultrasound (EUS), and endoscopic transpapillary gallbladder drainage (ETGBD)
under endoscopic retrograde cholangiopancreatography (ERCP).
Could be usefull for the readers to mention this alternative drainage methods in the manuscript.
Please comment this topic in the discussion including these reviews in the manuscript.
assistant