Review for 10.1186/s12876-023-02808-1 (2023)

Reviewer’s report
Title: 
Partial splenic embolization as a rescue and emergency treatment
for portal hypertension and gastroesophageal variceal hemorrhage
Version: 
0 
Date: 
25 Feb 2023
Reviewer's report:
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This is a retrospective study reported that outcome of applying PSE in treating
patients with portal hypertension-related UGI bleeding (mainly were EV
bleeding). The major limitation as lack of novelty as the efficacy of PSE in
treatment of EV bleeding has been shown in a meta-analysis (reference number
2). Another major limitation was that the included patients had a mixed
characteristic in terms of disease's prognosis. Some of them were refractory EV
bleeding and some were non-cirrhotic portal hypertension. Theoretically,
patients with non-cirrhotic PHT with EV bleeding have a much better prognosis
than those with cirrhotic patients with EV bleeding. In addition, the authors also
included patients with GV bleeding (without the information on the exact
indictions for PSE i.e., endoscopic failure or PSE was done as a primary
treatment), and also 1 patient with bleeding PHG and refractory ascites.
Therefore, the title of the study (wording "rescue strategy" and "emergency
management of gastroesophageal variceal hemorrhage") was not truly match
with the included subjects.
Minor comments:
1. Many information in the text and tables/figures are repetitive, for example
table 2 and 3, figure 3D and 4. They can be removed.
2. One patient died 4 weeks after PSE duo to ACLF but was considered a non-
procedural related death. How can the authors assure that the cause of death was
non-PSE related?
3. "Five partients needed a repeated PSE due to recurrent varices". This
information should be clarified. 
4. Before the discussion, the authors used the term "rescue treatment of
gastroesophageal variceal hemorrhage", actually PSE was not entirely performed
as a rescue treatment of EV bleeding.
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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?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
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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