Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 05 Sep 2024
Reviewer's report:
I would like to congratulate for your work ragarding this quite difficult to assess clinical
condition. Looks like a dedicated team came through all the invasive steps an that is challenging.
even if this is not the  standard treatment of Portal hypertension presented with UGIB, still
remains an important tool.
As far as my understanding is , HVGP measurement even as the best indicator of HTN is qyite
invasive and laparoscopic approach even so is of high risk of morbidity and mortality. I think it
would be a good opportunity to clarify compications and decompensation rates in you cohort. As
you undestand is paramount to integrate all data since its difficult to standarised such a procedure
as devascularizzation -splenectomy in patients who are potential candidates for liver transplant.
Even if admire your dedication to the approach one could state that is not a step forard when
we try to integrate non invasive methods, scores or non invasive tools to better understand the
degree od PHTN.
Iwould be grateful if you could better clarify- in the discussion -  the absolute or relative
indications for the invasive procedure as you have described in your paper
Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 05 Sep 2024
Reviewer's report:
I would like to congratulate for your work ragarding this quite difficult to assess clinical
condition. Looks like a dedicated team came through all the invasive steps an that is challenging.
even if this is not the  standard treatment of Portal hypertension presented with UGIB, still
remains an important tool.
As far as my understanding is , HVGP measurement even as the best indicator of HTN is qyite
invasive and laparoscopic approach even so is of high risk of morbidity and mortality. I think it
would be a good opportunity to clarify compications and decompensation rates in you cohort. As
you undestand is paramount to integrate all data since its difficult to standarised such a procedure
as devascularizzation -splenectomy in patients who are potential candidates for liver transplant.
Even if admire your dedication to the approach one could state that is not a step forard when
we try to integrate non invasive methods, scores or non invasive tools to better understand the
degree od PHTN.
Iwould be grateful if you could better clarify- in the discussion -  the absolute or relative
indications for the invasive procedure as you have described in your paper
Please review this paper.
user
Title: The independent prognostic value of perioperative hepatic venous pressure gradient
measurements in patients with portal hypertension who underwent laparoscopic splenectomy
plus esophagogastric devascularization
Version: 2 Date: 05 Sep 2024
Reviewer's report:
I would like to congratulate for your work ragarding this quite difficult to assess clinical
condition. Looks like a dedicated team came through all the invasive steps an that is challenging.
even if this is not the  standard treatment of Portal hypertension presented with UGIB, still
remains an important tool.
As far as my understanding is , HVGP measurement even as the best indicator of HTN is qyite
invasive and laparoscopic approach even so is of high risk of morbidity and mortality. I think it
would be a good opportunity to clarify compications and decompensation rates in you cohort. As
you undestand is paramount to integrate all data since its difficult to standarised such a procedure
as devascularizzation -splenectomy in patients who are potential candidates for liver transplant.
Even if admire your dedication to the approach one could state that is not a step forard when
we try to integrate non invasive methods, scores or non invasive tools to better understand the
degree od PHTN.
Iwould be grateful if you could better clarify- in the discussion -  the absolute or relative
indications for the invasive procedure as you have described in your paper
assistant