Review for 10.1186/s12876-023-02862-9 (2023)

Reviewer’s report
Title: 
A New Classification of Periampullary Diverticulum: Cannulation of
Papilla on the Inner Margins of the Diverticulum (Type IIa) is More Challenging
Version: 
0 
Date: 
19 Mar 2023
Reviewer's report:
The authors suggested a new division of periampullary diverticulum (PAD).
There are some limitations in this paper.
1. There is a lack of evidence that the new division is superior to the previous
one. If authors want to prove the superiority of the new division, comparisons
that are more detailed should be presented. Cannulation time and difficulty
depend on ERCP endoscopists. Therefore, this should be remarked on and
corrected. The number of each type of PAD is lacking in having enough
statistical power. 
2. Even in experts, successful cannulation cannot be achieved in all patients. The
authors reported all patients were successfully cannulated. It is impossible.
3. According to the traditional division of PAD, the new division needs to be
modified. To reduce confusion, it would be better that type I and III represent
papilla inside and outside PAD. Type II can be divided IIA and IIB according to
papilla location (inner and outer margin).
4. The study method was not described. Is it retrospective or prospective? From
the contents, this study is probably retrospective. However, the introduction
contains 'prospectively'.
5. Statistical analysis and description should be revised and needs reports in
detail.
6. All perforation patients recovered without surgery. It needs a detailed
description of the perforation type.
7. There are no detailed limitations in the Discussion.
8. There are grammar errors and awkwardness in some sentences.
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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?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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