Title: Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography
Version: 2 Date: 12 Dec 2022
Reviewer's report:
The results of this study highlight the importance of adequate biliary drainage in patients
undergoing ERCP. In theory, bile is sterile. One of the important mechanisms that provides
this is the papillary sphincter structure. When endoscopic sphincterotomy and/or biliary stenting
removes this barrier during ERCP, the bile duct becomes contaminated. The bile duct is
contaminated with microorganisms either from the duodenum or from the oral cavity or
contaminated duodenoscope, as we understand from this study.
The growth of microorganisms in the bile duct in almost all patients, but this does not affect the
clinic shows the importance of drainage. This should be one of the main messages of the study.
Today, there are new studies claiming that disposable duodenoscopes will prevent biliary
infective complications due to microorganisms that cannot be removed during reprocessing.
The result of this study shows that even with a disposable duodenoscope, biliary contamination
cannot be reduced to zero as it would have to pass through the oral cavity.
The authors can also emphasize these points if they wish.
Title: Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography
Version: 2 Date: 12 Dec 2022
Reviewer's report:
The results of this study highlight the importance of adequate biliary drainage in patients
undergoing ERCP. In theory, bile is sterile. One of the important mechanisms that provides
this is the papillary sphincter structure. When endoscopic sphincterotomy and/or biliary stenting
removes this barrier during ERCP, the bile duct becomes contaminated. The bile duct is
contaminated with microorganisms either from the duodenum or from the oral cavity or
contaminated duodenoscope, as we understand from this study.
The growth of microorganisms in the bile duct in almost all patients, but this does not affect the
clinic shows the importance of drainage. This should be one of the main messages of the study.
Today, there are new studies claiming that disposable duodenoscopes will prevent biliary
infective complications due to microorganisms that cannot be removed during reprocessing.
The result of this study shows that even with a disposable duodenoscope, biliary contamination
cannot be reduced to zero as it would have to pass through the oral cavity.
The authors can also emphasize these points if they wish.
Please review this paper.
user
Title: Transmission of oral microbiota to the biliary tract during endoscopic retrograde
cholangiography
Version: 2 Date: 12 Dec 2022
Reviewer's report:
The results of this study highlight the importance of adequate biliary drainage in patients
undergoing ERCP. In theory, bile is sterile. One of the important mechanisms that provides
this is the papillary sphincter structure. When endoscopic sphincterotomy and/or biliary stenting
removes this barrier during ERCP, the bile duct becomes contaminated. The bile duct is
contaminated with microorganisms either from the duodenum or from the oral cavity or
contaminated duodenoscope, as we understand from this study.
The growth of microorganisms in the bile duct in almost all patients, but this does not affect the
clinic shows the importance of drainage. This should be one of the main messages of the study.
Today, there are new studies claiming that disposable duodenoscopes will prevent biliary
infective complications due to microorganisms that cannot be removed during reprocessing.
The result of this study shows that even with a disposable duodenoscope, biliary contamination
cannot be reduced to zero as it would have to pass through the oral cavity.
The authors can also emphasize these points if they wish.
assistant