Review for 10.1186/s12876-016-0486-4 (2016)

Reviewer ’s report  
Title:  Limited precut  sphincterotomy combined with endoscopic  papillary balloon dilation for 
common bile duct stone removal in patients with difficult biliary cannulation  
 
Version : 0 Date : 21 Apr 2016  
 
Reviewer:  Jacob Freedman  
 
Reviewer's report:  
Patients:  
258 patients had difficult cannulation but only 58 were i ncluded in the study, how were the rest 
handled?  
Exclusion criteria do not really apply in this retrospective study, all patients that had a limited PS 
combined with EPBD were included, or were there exclusions?  
Why stop aspirin before ERCP? That only incr eases the risks for a cardiovascular event. 
Coumadin and clopidogrel I get.  
Was any prophylactic agent given to reduce risk of post -ERCP pancreatitis (ie NSAID)  
 
Results  
The material is really much to small to do a multivariate analysis of risk factors for  pancreatitis, 
it is not surprising that you couldn't find significant correlations. I think that this analysis should 
be excluded.  
 
Discussion  
The number of patients and complications (pancreatits and bleeding) are so few that a 
meaningful discussion arou nd these topics is questionable. Better to focus on success rates and 
procedural times.  
 
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.  
Yes 
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 statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this  manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied f or patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give de tails below.  
I declare that I have no competing interests  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
inclu ding any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that a ny comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
I agree to the open peer review policy of the journal