Reviewer's report
Title:Endoscopic gallbladder stenting for acute cholecystitis: a retrospective
study of 46 elderly patients aged 65 years or older
Version: 3Date:18 February 2013
Reviewer: Steve Pereira
Reviewer's report:
Reviewer's report
In this retrospective study, Makawa and colleagues report on the safety and
efficacy of endoscopic gall bladder stenting in elderly patients with acute
cholecystitis who were poor surgical candidates, with 27 of 31 having either
cerebral infarction or dementia. Endoscopic gall bladder stenting (EGS) was
successful in 80% without immediate complications, with the remaining patients
going on to standard percutaneous drainage or aspiration.
Major Compulsory Revisions
1. In their accompanying letter dated 7 january 2013, the authors state that the
study was ethically approved and all patients gave written informed consent, yet
this was a retrospective study, 40/46 of the procedures were emergencies and
27/46 patients had cerebral infarction or dementia, so it is difficult to understand
how this was possible.
2. On page 5 it is stated that there were no immediate postprocedure
complications, which is extraordinary given that they were high risk elderly
patients undergoing emergency ERCP for gallbladder sepsis +/- CBD stone
removal. There is little detail as to how data were captured or complications
assessed, which may have been underestimated in a retrospective study. If
possible, it would be helpful to give some detail as to how sick the patients were
(ITU support, intubated, inotropes etc) and some information about the ERCP
and recovery setting. Reassuringly, the patients who had a successful EGS were
able to be discharged within a week.
Minor Essential Revisions
3. On page 6 it is stated with elective EGS was performed in 5 patients after
PTGBD, but the rationale for this is not clear. Were all these 5 patients in the
group of 31 patients in whom EGS was permanent and cholecystectomy not
performed?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Endoscopic gallbladder stenting for acute cholecystitis: a retrospective
study of 46 elderly patients aged 65 years or older
Version: 3Date:18 February 2013
Reviewer: Steve Pereira
Reviewer's report:
Reviewer's report
In this retrospective study, Makawa and colleagues report on the safety and
efficacy of endoscopic gall bladder stenting in elderly patients with acute
cholecystitis who were poor surgical candidates, with 27 of 31 having either
cerebral infarction or dementia. Endoscopic gall bladder stenting (EGS) was
successful in 80% without immediate complications, with the remaining patients
going on to standard percutaneous drainage or aspiration.
Major Compulsory Revisions
1. In their accompanying letter dated 7 january 2013, the authors state that the
study was ethically approved and all patients gave written informed consent, yet
this was a retrospective study, 40/46 of the procedures were emergencies and
27/46 patients had cerebral infarction or dementia, so it is difficult to understand
how this was possible.
2. On page 5 it is stated that there were no immediate postprocedure
complications, which is extraordinary given that they were high risk elderly
patients undergoing emergency ERCP for gallbladder sepsis +/- CBD stone
removal. There is little detail as to how data were captured or complications
assessed, which may have been underestimated in a retrospective study. If
possible, it would be helpful to give some detail as to how sick the patients were
(ITU support, intubated, inotropes etc) and some information about the ERCP
and recovery setting. Reassuringly, the patients who had a successful EGS were
able to be discharged within a week.
Minor Essential Revisions
3. On page 6 it is stated with elective EGS was performed in 5 patients after
PTGBD, but the rationale for this is not clear. Were all these 5 patients in the
group of 31 patients in whom EGS was permanent and cholecystectomy not
performed?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Endoscopic gallbladder stenting for acute cholecystitis: a retrospective
study of 46 elderly patients aged 65 years or older
Version: 3Date:18 February 2013
Reviewer: Steve Pereira
Reviewer's report:
Reviewer's report
In this retrospective study, Makawa and colleagues report on the safety and
efficacy of endoscopic gall bladder stenting in elderly patients with acute
cholecystitis who were poor surgical candidates, with 27 of 31 having either
cerebral infarction or dementia. Endoscopic gall bladder stenting (EGS) was
successful in 80% without immediate complications, with the remaining patients
going on to standard percutaneous drainage or aspiration.
Major Compulsory Revisions
1. In their accompanying letter dated 7 january 2013, the authors state that the
study was ethically approved and all patients gave written informed consent, yet
this was a retrospective study, 40/46 of the procedures were emergencies and
27/46 patients had cerebral infarction or dementia, so it is difficult to understand
how this was possible.
2. On page 5 it is stated that there were no immediate postprocedure
complications, which is extraordinary given that they were high risk elderly
patients undergoing emergency ERCP for gallbladder sepsis +/- CBD stone
removal. There is little detail as to how data were captured or complications
assessed, which may have been underestimated in a retrospective study. If
possible, it would be helpful to give some detail as to how sick the patients were
(ITU support, intubated, inotropes etc) and some information about the ERCP
and recovery setting. Reassuringly, the patients who had a successful EGS were
able to be discharged within a week.
Minor Essential Revisions
3. On page 6 it is stated with elective EGS was performed in 5 patients after
PTGBD, but the rationale for this is not clear. Were all these 5 patients in the
group of 31 patients in whom EGS was permanent and cholecystectomy not
performed?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
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