Review for 10.1186/1471-230X-9-18 (2009)

Reviewer's report
Title:First attack of acute pancreatitis in Sweden 1988 - 2003: incidence,
aetiological classification, procedures and mortality - a register study
Version: 1Date:27 October 2008
Reviewer: Raffaele Pezzilli
Reviewer's report:
Major Compulsory Revisions
1. The first sentence of Procedures on page 6 is quite confusing and should be
extensively revised.
2. The authors studied the incidence, etiological classification procedures and
mortality for patients with first attack of acute pancreatitis utilizing nationwide
data. It seems that on the basis of the data contained in the register it is not
possible to evaluate the severity of acute pancreatitis; thus the comments of the
first sentence of page 10 as well as the comments of the second and the third
sentence on the same page cannot be drawn on the basis of the data reported.
Minor essential revisions
3. The 51 patients with both biliary and alcoholic origin of acute pancreatitis
should be grouped separately from the alcoholic forms.
4. Regarding the operative procedures the authors should be mention the
following references: Gurusamy KS, Samraj K, Fusai G, Davidson BR. Early
versus delayed laparoscopic cholecystectomy for biliary colic. Cochrane
Database Syst Rev. 2008 Oct 8;(4):CD007196. de Carvalho FR, dos Santos JS,
Elias Junior J, Kemp R, Sankarankutty AK, Fukumori OY, Souza MC, de
Castro-e-Silva O. The influence of treatment access regulation and technological
resources on the mortality profile of acute biliary pancreatitis. Acta Cir Bras.
2008;23 Suppl 1:143-50. Connor SJ, Lienert AR, Brown LA, Bagshaw PF.
Closing the audit loop is necessary to achieve compliance with evidence-based
guidelines in the management of acute pancreatitis. N Z Med J. 2008 Jun
6;121(1275):19-25. Andersen AM, Novovic S, Ersbøll AK, Hansen MB. Mortality
in alcohol and biliary acute pancreatitis. Pancreas. 2008 May;36(4):432-4.
McCullough L, Sutherland F, Preshaw R, Kim S. Gallstone pancreatitis: does
discharge and readmission for cholecystectomy affect outcome? HPB (Oxford).
2003;5(2):96-9. Pezzilli R, Uomo G, Gabbrielli A, Zerbi A, Frulloni L, De Rai P,
Castoldi L, Cavallini G, Di Carlo V; ProInf-AISP Study Group. A prospective
multicentre survey on the treatment of acute pancreatitis in Italy. Dig Liver Dis.
2007 Sep;39(9):838-46.O'Farrell A, Allwright S, Toomey D, Bedford D, Conlon K.
Hospital admission for acute pancreatitis in the Irish population, 1997 2004: could
the increase be due to an increase in alcohol-related pancreatitis? J Public
Health (Oxf). 2007 Dec;29(4):398-404.
Discretionary revision
1. Introduction section, Page 2 line 1: The author refer to both pain and vomiting
as clinical features acute pancreatitis: the main clinical feature of acute
pancreatitis is the pain.
2. Introduction section, Page 2 line 1: The authors report that the diagnosis of
acute pancreatitis is based on clinical features together with elevation of plasma
concentrations of pancreatic enzymes, if indicated supplemented by CT scan. In
my opinion CT scan should be replaced by “imaging techniques” (CT, RMI, US).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests