Submited on: 26 Sep 2014 08:29:03 PM GMT
Published on: 27 Sep 2014 04:27:52 AM GMT
 
Missed Gallstones in the abdominal wall; case report
Posted by Mr. Shlok Balupuri on 23 Mar 2015 07:47:59 PM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The case report highlights the occasional diagnostic delimma faced by surgeons when previous spillage of gallstones has not been documented in original operative notes. The spillage is common and its adequate retrival in a bag will obviate such presentations. 


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    It is not novel, with many cases faced by high volume surgeos especially subspeciallising in HPB. A low index of suspicion should exist after cholecystectomy in abscess formation post operatively.


  • Are the claims properly placed in the context of the previous literature?

    yes


  • Do the results support the claims? If not, what other evidence is required?

    In case of diagnostic delimma, better imaging ,i,e CT or MRI would have been appropriate.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    It is a case report


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Imaging and low index of suspicion


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No. A common condition which could be picked up if low index of suspicion was entertained.


  • Other Comments:

    The language syntax is lacking which does not distract from the message however. It might be advisable to correct spelling and grammatical errors within the report. 

    Overall, appropriate message conveyed by the report.

    Please note of the reports of extensive investigations of Liver lesions which turn out to be spilled gallstones!

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    GB polyps, Colonic gallstones

  • Experience and credentials in the specific area of science:

    UGI/HPB consultant surgeon

  • How to cite:  Balupuri S .Missed Gallstones in the abdominal wall; case report[Review of the article 'Missed Gallstone in the abdominal wall; case report ' by Al Adwani M].WebmedCentral 2015;6(3):WMCRW003199
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Missed Gallstones in the abdomina lwall:caes report
Posted by Dr. Prasan K Hota on 29 Sep 2014 08:37:57 AM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    Missed gallstones in the abdominal wall are commonly reported, though associated hernia is rare. recovery of gall bladder from the abdomen usually is done through a retrieval bag. this ensures safe retrieval of the gall bladder without causing any injury, hence there does not arise any chance of stone spillage during the retrival process. If the gall bladder is brought out directly without using a retrieval bag, then the gall bladder may rupture en route and stones may spill into the peritoneal cavity or even inside the abdominal wall. If any of these spilled stone is not retrieved carefully, then these stones in the abdominal wall can cause infection and persistent sinus. Hernia through the ports, particularly through 10mm ports can occur if the port is not closed. However the combination of both these factors can lead to the clinical scenario as described by the authors.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    NA


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes. 


  • Other Comments:

    It is a good paper for publication. It gives a clear warning that the gall bladder should be retrieved through a bag and the 10mm port should be closed to avoid the port hernia and infection at the port site.

  • Competing interests:
    Nil
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:

    No

  • Experience and credentials in the specific area of science:

    I have seen a number of cases with retained gallstones in the abdominal wall as well as port hernias and managed them. However retained stones with port hernia is new for me.

  • How to cite:  Hota P K.Missed Gallstones in the abdomina lwall:caes report[Review of the article 'Missed Gallstone in the abdominal wall; case report ' by Al Adwani M].WebmedCentral 2015;5(9):WMCRW003114
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Title is acceptable.
Posted by Dr. KETAN R VAGHOLKAR on 27 Sep 2014 05:45:34 AM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The paper highlights the problems associated with retained or spilled stones which is quite common in laparoscopic gall bladder surgery.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims are genuine and are awarning to general surgeons to be careful during surgery.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable to this paper as it is a case report.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Not really.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    As a case prsentation.


  • Other Comments:

    NA

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:

    None

  • Experience and credentials in the specific area of science:

    NA

  • How to cite:  VAGHOLKAR K R.Title is acceptable.[Review of the article 'Missed Gallstone in the abdominal wall; case report ' by Al Adwani M].WebmedCentral 2015;5(9):WMCRW003113
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