The Role of Lumen Apposing Metal Stents in the Palliation of Distal Malignant Biliary Distal Obstruction
Katsuya Kitamura
Round 1
Reviewer 1 Report
well done and interesting paper to read and to know about
Author Response
thank you for the kind review
Reviewer 2 Report
Voiosu et al aimed to review all the available evidence on the role of EUS-BD performed with EC-LAMSs and discuss salient technical aspects of this type of procedure. The review is well structured and clear. No specific comment from my point of view.
Author Response
thank you for the kind review
Reviewer 3 Report
EUS-CDS with LAMS for distal malignant bile duct obstruction has advantages indrainage, but whether it outperforms ERCP capable of diagnosis and treatment requires further discussion. On the other hand, EUS-HGS is one of the promising treatments for malignant bile duct obstruction with duodenal stenosis and postoperative intestinal reconstruction. Please add these points.
EUS-CDS with LAMS for distal malignant bile duct obstruction has advantages indrainage, but whether it outperforms ERCP capable of diagnosis and treatment requires further discussion. On the other hand, EUS-HGS is one of the promising treatments for malignant bile duct obstruction with duodenal stenosis and postoperative intestinal reconstruction. Please add these points.
Author Response
thank the reviewer for the kind suggestions, we included a segment on EUS HGS as an important alternative to EUSBD with LAMS in the section on altered anatomy.
Reviewer 4 Report
I am also attaching the PDF text of the article with the corrections inserted in the notes to which I would rather add that the Bibliography needs to be reviewed as in some references there is the DOI in others it is not!
Comments for author File: 
Comments.pdf
Moderate editing of English language
Author Response
thank you for the suggestions, we have edited the references and the manuscript accordingly.
