Title: Title # Endoscopic nasobiliary drainage-based saline-injection ultrasound: an  imaging
technique for remnant stone detection after retrograde cholangiopancreatography
Version: 6 Date: 26 May 2022
Reviewer's report:
Thank you for the opportunity to review this interesting article : "Endoscopic nasobiliary
drainage-based saline-injection ultrasound: an  imaging technique for remnant stone detection
after retrograde cholangiopancreatography".
The article has improved with the corrections made by the authors.
The use of ENBD saline injections to enhance sonographic image is very interesting particulary
in pregnant patients and in patients with iodine allergy and can aggregate to the diagnostic
tools for remnant stone detection. However, the use of ENBD has some drawbacks since it is
uncomfortable to the patient and requires special care to avoid dislodgement and  is the reason
why it has been increasingly replaced by biliary stents.
The accuracy of ENBD-based saline-injection US that is the objective of this study is not
mentioned in the conclusion, only sensitivity and specificity. Estimated accuracy of 96.8%
should be mentioned in the results.
EUS for detection of remnant stone and biliary sludge after ERCP has been evaluated by Sagami
R et al  (2022) and Yeon-Ji K et al (2019). Although it is a more invasive procedure it seems
to be also very accurate and should be addressed.
Title: Title # Endoscopic nasobiliary drainage-based saline-injection ultrasound: an  imaging
technique for remnant stone detection after retrograde cholangiopancreatography
Version: 6 Date: 26 May 2022
Reviewer's report:
Thank you for the opportunity to review this interesting article : "Endoscopic nasobiliary
drainage-based saline-injection ultrasound: an  imaging technique for remnant stone detection
after retrograde cholangiopancreatography".
The article has improved with the corrections made by the authors.
The use of ENBD saline injections to enhance sonographic image is very interesting particulary
in pregnant patients and in patients with iodine allergy and can aggregate to the diagnostic
tools for remnant stone detection. However, the use of ENBD has some drawbacks since it is
uncomfortable to the patient and requires special care to avoid dislodgement and  is the reason
why it has been increasingly replaced by biliary stents.
The accuracy of ENBD-based saline-injection US that is the objective of this study is not
mentioned in the conclusion, only sensitivity and specificity. Estimated accuracy of 96.8%
should be mentioned in the results.
EUS for detection of remnant stone and biliary sludge after ERCP has been evaluated by Sagami
R et al  (2022) and Yeon-Ji K et al (2019). Although it is a more invasive procedure it seems
to be also very accurate and should be addressed.
Please review this paper.
user
Title: Title # Endoscopic nasobiliary drainage-based saline-injection ultrasound: an  imaging
technique for remnant stone detection after retrograde cholangiopancreatography
Version: 6 Date: 26 May 2022
Reviewer's report:
Thank you for the opportunity to review this interesting article : "Endoscopic nasobiliary
drainage-based saline-injection ultrasound: an  imaging technique for remnant stone detection
after retrograde cholangiopancreatography".
The article has improved with the corrections made by the authors.
The use of ENBD saline injections to enhance sonographic image is very interesting particulary
in pregnant patients and in patients with iodine allergy and can aggregate to the diagnostic
tools for remnant stone detection. However, the use of ENBD has some drawbacks since it is
uncomfortable to the patient and requires special care to avoid dislodgement and  is the reason
why it has been increasingly replaced by biliary stents.
The accuracy of ENBD-based saline-injection US that is the objective of this study is not
mentioned in the conclusion, only sensitivity and specificity. Estimated accuracy of 96.8%
should be mentioned in the results.
EUS for detection of remnant stone and biliary sludge after ERCP has been evaluated by Sagami
R et al  (2022) and Yeon-Ji K et al (2019). Although it is a more invasive procedure it seems
to be also very accurate and should be addressed.
assistant