Review for 10.1186/s12876-016-0479-3 (2016)

Reviewer ’s report  
 
Title: Liver Elasticity Measurement Before and After Biliary Drainage in Patients With  
Obstructive Jaundice -A Prospect ive Cohort Study  
 
Version: 1 Date: 05 Mar 2016  
 
Reviewer: Kidist Yimam  
 
Reviewer's report:  
 
1. Thank you for performing the additional analysis to evaluate correlation between changes in 
ALP with change in hepatic elasticity (TE, VTQ -R and VTQ -L). Though the correlations 
were weak, consider including in your paper (at least in the discussion part) as readers will 
likely question if ALP may correlate better the TB.  
2. Page 18, line 27: regarding "patient selection" consider making it more to readers to why 
TB/ALP changes did not correlate well with TE, VTQ -R and VTQ -L.  
In addition to the small sample, all your patients were patients with malignant biliary obstruction 
of unknown duration, with possible sec ondary biliary fibrosis. We also don't how the location of 
the biliary obstruction affects TE or VTE -R/L values as the location of the malignant 
obstructions varied in your patient cohort.  
3. Page 18, line 34: "primary liver fibrosis" should be changed "secondary biliary fibrosis" due 
to extrahepatic obstruction. The authors have excluded patients with underlying chronic liver 
diseases.  
4. Overall, this study can be of interest as a proof o f concept. Though it has been previously 
reported that biliary obstruction can increase liver stiffness measured by TE, the correlation 
between change in hepatic elasticity and serum markers of fibrosis before and after 
alleviating biliary obstruction is i nteresting to report.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls ? 
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 statis tics 
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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