Controversies in Endoscopic Ultrasound-Guided Biliary Drainage

Round 1

Reviewer 1 Report

This was a very well-done study and the data reported is succinct and well-presented. After carefully review this paper, I think this paper was still need further revision and add some detail information for future decision.

1.      In figure 2, please re-arrangement figure 2b and 2c. The endoscopy picture was in left side and radiologic picture in right side.

2.      In “Arguments against EUS-guided drainage” part

According to a previous study, the most common concomitant chronic dis[1]ease in elderly adults who undergo ERCP is cardiovascular disease (44.6–57.6%), with concomitant cerebrovascular disease rates of approximately 8% to 18.2% in elderly adults. Many of these individuals are treated with long[1]term antiplatelet or antithrombotic agents.

The EUS-guided drainage was also high bleeding procedure. Authors might consider addressed the possibility of bleeding risk of EUS-guided drainage when them had accepted  antiplatelet or antithrombotic agents treatment.

Author Response

please see attachement

Author Response File: Author Response.pdf

Reviewer 2 Report

l   This manuscript performed a valuable review about the evolving aspect of biliary drainage techniques, emphasizing the usefulness of EUS-guided approaches as alternatives to traditional methods.

l   This review also provides a lot of comprehensive information that would be helpful for hepato-biliary physician when dealing with the complexities and controversies about EUS-guided biliary drainage. It includes a balanced overview of the related advantages, limitations, and areas to be further investigated.

Author Response

We very much thank and appreciate the very kind review.

Reviewer 3 Report

Comments for author File: Comments.pdf

Author Response

We very much thank and appreciate the very kind review.

Reviewer 4 Report

The article is a literature review. The authors discuss the advantages and disadvantages of modern high-tech methods of drainage of the biliary tract in patients with biliary stenosis of various etiologies. The authors give recommendations on the use of these technologies in a really clinical situation. The article is recommended for publication. The paper can be accepted without any further changes. 

Author Response

We very much thank and appreciate the very kind review. 

Round 2

Reviewer 1 Report

This was a very well done study and the data reported is succinct and well-presented. Authors had complete response the previous reviewers’ suggestion and revised well. May consider accepted this article.