Review for 10.1186/s12876-022-02610-5 (2022)

Reviewer’s report
Title: 
Long-term outcomes of endoscopic transpapillary gallbladder drainage
using a novel spiral plastic stent in acute calculus cholecystitis
Version: 
0 
Date: 
02 May 2022
Reviewer's report:
The authors evaluated a unique shaped plastic stent designed for EGBS. The
stent had been evaluated in their previous study and the current study showed its
long-term outcome. While I appreciate the effort of the work, I think the authors
needs to improve the focus of the paper.
1) In the previous their report (Nakahara K, et al. Endosc Int Open 2019), it
comapred the stent with other types of stents and its follow-up period was 120-
160 days. On the other hand, the follow-up period was 236 days in the current
study. Although the follow-up period extended, I wonder if the result is regarded
as a long-term outcome. I think most of the result might be overlapped with their
previous work.
2) There have been few reports about EGBS used as bridge-to-surgery.
Therefore, the outcome of cholecystectomy after EGBS might be more
important. 
3) Why did the authors exclude acalculus cholecystitis? 
4) What was recurrent biliary obstruction? Did it mean recurrence of
cholecystitis or cholangitis? Please define the term in the Method section.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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