Endoscopic Internalization by Cutting the Endoscopic Transpapillary Nasogallbladder Drainage Tube in Management of Acute Cholecystitis: A Retrospective Multicenter Cohort Study

Round 1

Reviewer 1 Report

Excellent and interesting clinical work!

I am in favour of acceptance of this original paper after minor English language spell check!

Reviewer 2 Report

In this study, the authors aimed to evaluate the feasibility, efficacy and safety of endoscopic internalization by cutting an endoscopic nasogallbladder drainage (ENGBD) tube for acute cholecystitis. With use of the defined procedure, they found a technical success rate of 90.5%, and a clinical success rate of 100%. They concluded that endoscopic internalization by cutting the ENGBD tube after improvement of cholecystitis could be an effective and safe treatment option for preventing recurrent cholecystitis in the waiting period until cholecystectomy. The study, which presents the advantages of an alternative treatment method, is well designed and adequately written. I congratulate the authors for their successful work.

Reviewer 3 Report

I find as an interesting subject and currently under discussion.

Management of acute cholecystitis has traditionally been performed by conservative management with antimicrobials pending resolution or by performing emergency cholecystectomy with high morbidity and mortality rates, especially the possibility of injury to the main bile duct.

Recently, several endoscopic procedures have appeared, such as the one presented by the authors that undoubtedly allow the acute picture to be managed for the performance of cholecystectomy in better conditions and without so much risk

The article is well written, orderly, with a satisfactory statistical analysis and with real figures of the procedure.