Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  16 March 2007 Version: Date: 
 Greger Lindberg Reviewer: 
Reviewer's report: 
General 
This is a systematic review of literature data on efficacy, complications, and costs of treatment alternatives 
in malignant gastric outlet obstruction. Stenting is a new technique that has been applied in many places 
without good evidence for its superiority to previous techniques including open or laparoscopic by-pass with 
gastrojejunostomy. The authors have used recommended techniques for the analysis of published data. 
There is a lack of randomized studies in this area and their conclusion is that there is insufficient data to 
give a firm recommendation regarding the choice between stenting and operative by-pass in the case of malignant gastric outlet obstruction. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) I have no major revisions to suggest. ------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
I have no minor essential revisions to suggest. ------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I am a little surprised by the abbreviation GJJ for gastrojejunostomy. Wouldn't GJS be more adequate? Not 
many centres, at least not in Europe, have large numbers of patients that would be suitable for a 
randomized study. I think this is a typical area in which a cooperative multinational study should be initiated. 
Perhaps the authors could provide some estimate on the expected annual number of adult patients per 
million inhabitants who would need this kind of treatment per year. 
 Accept after discretionary revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  16 March 2007 Version: Date: 
 Greger Lindberg Reviewer: 
Reviewer's report: 
General 
This is a systematic review of literature data on efficacy, complications, and costs of treatment alternatives 
in malignant gastric outlet obstruction. Stenting is a new technique that has been applied in many places 
without good evidence for its superiority to previous techniques including open or laparoscopic by-pass with 
gastrojejunostomy. The authors have used recommended techniques for the analysis of published data. 
There is a lack of randomized studies in this area and their conclusion is that there is insufficient data to 
give a firm recommendation regarding the choice between stenting and operative by-pass in the case of malignant gastric outlet obstruction. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) I have no major revisions to suggest. ------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
I have no minor essential revisions to suggest. ------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I am a little surprised by the abbreviation GJJ for gastrojejunostomy. Wouldn't GJS be more adequate? Not 
many centres, at least not in Europe, have large numbers of patients that would be suitable for a 
randomized study. I think this is a typical area in which a cooperative multinational study should be initiated. 
Perhaps the authors could provide some estimate on the expected annual number of adult patients per 
million inhabitants who would need this kind of treatment per year. 
 Accept after discretionary revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
Please review this paper.
user
Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  16 March 2007 Version: Date: 
 Greger Lindberg Reviewer: 
Reviewer's report: 
General 
This is a systematic review of literature data on efficacy, complications, and costs of treatment alternatives 
in malignant gastric outlet obstruction. Stenting is a new technique that has been applied in many places 
without good evidence for its superiority to previous techniques including open or laparoscopic by-pass with 
gastrojejunostomy. The authors have used recommended techniques for the analysis of published data. 
There is a lack of randomized studies in this area and their conclusion is that there is insufficient data to 
give a firm recommendation regarding the choice between stenting and operative by-pass in the case of malignant gastric outlet obstruction. ------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) I have no major revisions to suggest. ------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
I have no minor essential revisions to suggest. ------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
I am a little surprised by the abbreviation GJJ for gastrojejunostomy. Wouldn't GJS be more adequate? Not 
many centres, at least not in Europe, have large numbers of patients that would be suitable for a 
randomized study. I think this is a typical area in which a cooperative multinational study should be initiated. 
Perhaps the authors could provide some estimate on the expected annual number of adult patients per 
million inhabitants who would need this kind of treatment per year. 
 Accept after discretionary revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests 
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