Reviewer's report
Title:Assessment of intrahepatic blood flow by Doppler ultrasonography:
relationship between the hepatic vein, portal vein, hepatic artery and portal
pressure measured intraoperatively in patients with portal hypertension
Version: 5Date:13 May 2011
Reviewer: Annalisa Berzigotti
Reviewer's report:
The authors partially answered to the criticisms previously raised.
Minor Essential Revisions
The only accepted indication for shunt surgery in portal hypertension is
secondary prophylaxis (history of recurrent variceal bleeding) in Child A patients
(De Franchis et al. Baveno V consensus conference, J Hepatology 2010); in
patients with ascites transjugular intrahepatic porto-systemic shunt has to be
preferred due to a lower mortality related to the procedure. Prophylactic surgery
in patients who have not bled yet is contraindicated due to its high risk
(Consensus conference of Baveno III and IV).
Since some of the patients included in the present paper were treated with
derivative surgery as a primary prophylaxis (3 patients underwent shunt surgery
for hyperdynamic syndrome alone and 4 due to "CT showing cirrhosis with large
tubercules), I think the authors should include in the text:
1) the number/percentage of patients with an history of variceal bleeding
2) the detailed indications of derivative surgery in their Hospital
3) the indication of derivative surgery in all the patients included in the present
study
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Assessment of intrahepatic blood flow by Doppler ultrasonography:
relationship between the hepatic vein, portal vein, hepatic artery and portal
pressure measured intraoperatively in patients with portal hypertension
Version: 5Date:13 May 2011
Reviewer: Annalisa Berzigotti
Reviewer's report:
The authors partially answered to the criticisms previously raised.
Minor Essential Revisions
The only accepted indication for shunt surgery in portal hypertension is
secondary prophylaxis (history of recurrent variceal bleeding) in Child A patients
(De Franchis et al. Baveno V consensus conference, J Hepatology 2010); in
patients with ascites transjugular intrahepatic porto-systemic shunt has to be
preferred due to a lower mortality related to the procedure. Prophylactic surgery
in patients who have not bled yet is contraindicated due to its high risk
(Consensus conference of Baveno III and IV).
Since some of the patients included in the present paper were treated with
derivative surgery as a primary prophylaxis (3 patients underwent shunt surgery
for hyperdynamic syndrome alone and 4 due to "CT showing cirrhosis with large
tubercules), I think the authors should include in the text:
1) the number/percentage of patients with an history of variceal bleeding
2) the detailed indications of derivative surgery in their Hospital
3) the indication of derivative surgery in all the patients included in the present
study
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Assessment of intrahepatic blood flow by Doppler ultrasonography:
relationship between the hepatic vein, portal vein, hepatic artery and portal
pressure measured intraoperatively in patients with portal hypertension
Version: 5Date:13 May 2011
Reviewer: Annalisa Berzigotti
Reviewer's report:
The authors partially answered to the criticisms previously raised.
Minor Essential Revisions
The only accepted indication for shunt surgery in portal hypertension is
secondary prophylaxis (history of recurrent variceal bleeding) in Child A patients
(De Franchis et al. Baveno V consensus conference, J Hepatology 2010); in
patients with ascites transjugular intrahepatic porto-systemic shunt has to be
preferred due to a lower mortality related to the procedure. Prophylactic surgery
in patients who have not bled yet is contraindicated due to its high risk
(Consensus conference of Baveno III and IV).
Since some of the patients included in the present paper were treated with
derivative surgery as a primary prophylaxis (3 patients underwent shunt surgery
for hyperdynamic syndrome alone and 4 due to "CT showing cirrhosis with large
tubercules), I think the authors should include in the text:
1) the number/percentage of patients with an history of variceal bleeding
2) the detailed indications of derivative surgery in their Hospital
3) the indication of derivative surgery in all the patients included in the present
study
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
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