Reviewer ’s report  
 
Title: Analysis of risk factors related to gastrointestinal fistula in patients wi th severe acute 
pancreatitis: A Retrospective Study of 344 Cases in a Single Chinese Center  
 
Version: 0 Date: 29 Nov 2016  
 
Reviewer: Fuyuhiko Motoi  
 
Reviewer's report:  
 
Hua Z et al reported the Analysis of risk factors related to gastrointestinal fistula (GIF) in 
patients with severe acute pancreatitis as A Retrospective Study of 34 4 Cases in a Single Chinese 
Center.  Although the manuscript might have some interests in this field, there are many issues to 
be addressed.  
 
Major comments;  
1) There might be various severity of GIF in this series. Some cases of the GIF were simple and 
localized. The others were multiple or diffuse.  
1. Please describe the onset of the GIF more precisely. Were the onset of the localized GIF 
and diffuse GIF same?  
2. The management and outcome showed quite difference in these types of GIF. The analysis 
of pr ognostic factors for diffuse (severe) GIF would be better to show. Were the risk 
factors for whole GIF or for diffuse GIF same or different? Please discuss.  
2) Modified CT severity index (MCTSI) and Infected pancreatic and extra -pancreatic necrosis 
(IPN) might be correlated each other. Please comment and mention in the result.  
3) Please show the indication and contra -indication of EEN. The severe pancreatitis, which 
could not be managed by EEN might show GIF more frequently. This made a significant bias 
for the relation between the occurrence of GIF and EEN.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any  statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions : 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shar es in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you rec eived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interest s in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I have no competing interests.  
 
I agree to the open peer review policy  of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do n ot wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Analysis of risk factors related to gastrointestinal fistula in patients wi th severe acute 
pancreatitis: A Retrospective Study of 344 Cases in a Single Chinese Center  
 
Version: 0 Date: 29 Nov 2016  
 
Reviewer: Fuyuhiko Motoi  
 
Reviewer's report:  
 
Hua Z et al reported the Analysis of risk factors related to gastrointestinal fistula (GIF) in 
patients with severe acute pancreatitis as A Retrospective Study of 34 4 Cases in a Single Chinese 
Center.  Although the manuscript might have some interests in this field, there are many issues to 
be addressed.  
 
Major comments;  
1) There might be various severity of GIF in this series. Some cases of the GIF were simple and 
localized. The others were multiple or diffuse.  
1. Please describe the onset of the GIF more precisely. Were the onset of the localized GIF 
and diffuse GIF same?  
2. The management and outcome showed quite difference in these types of GIF. The analysis 
of pr ognostic factors for diffuse (severe) GIF would be better to show. Were the risk 
factors for whole GIF or for diffuse GIF same or different? Please discuss.  
2) Modified CT severity index (MCTSI) and Infected pancreatic and extra -pancreatic necrosis 
(IPN) might be correlated each other. Please comment and mention in the result.  
3) Please show the indication and contra -indication of EEN. The severe pancreatitis, which 
could not be managed by EEN might show GIF more frequently. This made a significant bias 
for the relation between the occurrence of GIF and EEN.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any  statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions : 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shar es in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you rec eived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interest s in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I have no competing interests.  
 
I agree to the open peer review policy  of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do n ot wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Analysis of risk factors related to gastrointestinal fistula in patients wi th severe acute 
pancreatitis: A Retrospective Study of 344 Cases in a Single Chinese Center  
 
Version: 0 Date: 29 Nov 2016  
 
Reviewer: Fuyuhiko Motoi  
 
Reviewer's report:  
 
Hua Z et al reported the Analysis of risk factors related to gastrointestinal fistula (GIF) in 
patients with severe acute pancreatitis as A Retrospective Study of 34 4 Cases in a Single Chinese 
Center.  Although the manuscript might have some interests in this field, there are many issues to 
be addressed.  
 
Major comments;  
1) There might be various severity of GIF in this series. Some cases of the GIF were simple and 
localized. The others were multiple or diffuse.  
1. Please describe the onset of the GIF more precisely. Were the onset of the localized GIF 
and diffuse GIF same?  
2. The management and outcome showed quite difference in these types of GIF. The analysis 
of pr ognostic factors for diffuse (severe) GIF would be better to show. Were the risk 
factors for whole GIF or for diffuse GIF same or different? Please discuss.  
2) Modified CT severity index (MCTSI) and Infected pancreatic and extra -pancreatic necrosis 
(IPN) might be correlated each other. Please comment and mention in the result.  
3) Please show the indication and contra -indication of EEN. The severe pancreatitis, which 
could not be managed by EEN might show GIF more frequently. This made a significant bias 
for the relation between the occurrence of GIF and EEN.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any  statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions : 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shar es in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you rec eived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interest s in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I have no competing interests.  
 
I agree to the open peer review policy  of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do n ot wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant