Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 1 Date: 14 Oct 2024
Reviewer's report:
The authors assessed the use of laparoscopic retroperitoneal pancreatic necrosectomy for
treating infected pancreatic necrosis with duodenal fistula in a s retrospective cohort study. The
manuscript is well written and the previous reviewers concerns were addressed appropriately .
However, in its current from the manuscript still has severe flaws that preclude publication:
1.  The authors mention  irrigation through the drains placed. The rationale for this  should be
explained and literature cited that supports it.
2. The authors should state if  the duodenal fistula treated specifically or just via necrosecomy.
3. The authors state different causes for the fistula. Hoe were these identified? How was the
presumed cause proven?
4. The authors state that 47.6% of fistula were identified in intraoperatively and not prior
to surgery. However the control group concludes patients that were not treated by surgery.
Therefore, the authors cannot be sure whether fistula were present in the control group and just
not detected due to no surgery being performed. Therefore, both the study as well as the control
group should only consist of patients that underwent surgery.
Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 1 Date: 14 Oct 2024
Reviewer's report:
The authors assessed the use of laparoscopic retroperitoneal pancreatic necrosectomy for
treating infected pancreatic necrosis with duodenal fistula in a s retrospective cohort study. The
manuscript is well written and the previous reviewers concerns were addressed appropriately .
However, in its current from the manuscript still has severe flaws that preclude publication:
1.  The authors mention  irrigation through the drains placed. The rationale for this  should be
explained and literature cited that supports it.
2. The authors should state if  the duodenal fistula treated specifically or just via necrosecomy.
3. The authors state different causes for the fistula. Hoe were these identified? How was the
presumed cause proven?
4. The authors state that 47.6% of fistula were identified in intraoperatively and not prior
to surgery. However the control group concludes patients that were not treated by surgery.
Therefore, the authors cannot be sure whether fistula were present in the control group and just
not detected due to no surgery being performed. Therefore, both the study as well as the control
group should only consist of patients that underwent surgery.
Please review this paper.
user
Title: Efficiency of laparoscopic retroperitoneal pancreatic necrosectomy for treating infected
pancreatic necrosis with duodenal fistula: A single-center retrospective cohort study
Version: 1 Date: 14 Oct 2024
Reviewer's report:
The authors assessed the use of laparoscopic retroperitoneal pancreatic necrosectomy for
treating infected pancreatic necrosis with duodenal fistula in a s retrospective cohort study. The
manuscript is well written and the previous reviewers concerns were addressed appropriately .
However, in its current from the manuscript still has severe flaws that preclude publication:
1.  The authors mention  irrigation through the drains placed. The rationale for this  should be
explained and literature cited that supports it.
2. The authors should state if  the duodenal fistula treated specifically or just via necrosecomy.
3. The authors state different causes for the fistula. Hoe were these identified? How was the
presumed cause proven?
4. The authors state that 47.6% of fistula were identified in intraoperatively and not prior
to surgery. However the control group concludes patients that were not treated by surgery.
Therefore, the authors cannot be sure whether fistula were present in the control group and just
not detected due to no surgery being performed. Therefore, both the study as well as the control
group should only consist of patients that underwent surgery.
assistant