Reviewer ’s report  
Title : Continuous suturing with two anterior layers reduces p ost-operative complications and 
hospitalization time in pancreaticoenterostomy  
 
Version:  0 Date : 11 Jan 2016  
 
Reviewer:  Luciana  Haddad  
 
Reviewer's report:  
This is a retrospective study to analy ze if continuous suturing with two anterior layers reduces 
post-operative complications and hospitalization time in pancreaticoenterostomy. Unfortunately, 
this study has many shortcomings that need to be addressed and include the following:  
1- It is a retr ospective study, with data taken from medical records, with all the associated 
biases  
2- The groups were not randomized or paired. The fact that the two techniques were performed 
in different periods can also lead to biases, as it can occur other developm ents treatments 
and conduct at the time.  
3. The number of patients is small  
4- The significant difference found between the 2 groups was when compared the sum of 
complications. In most cases, the complications found in the group "suturing Interrupt" 
occurr ed in the same group of patients. There were no differences specifically in relation to 
the occurrence of pancreatic fistula  
5- The studies by pancreatectomy techniques are difficult accomplishment, since they are 
rarely performed prospectively, randomized  study with a large number of participants. Thus, 
it is difficult to conclude in relation to the prevention of occurrence of pancreatic fistula and 
other complications.  
 
I suggest that the work is focused on the report of a new technique, if that is the ca se, not a 
comparative study.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments  to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the fo llowing questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content o f the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any  non-financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare that I  have no competing interests  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload  will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title : Continuous suturing with two anterior layers reduces p ost-operative complications and 
hospitalization time in pancreaticoenterostomy  
 
Version:  0 Date : 11 Jan 2016  
 
Reviewer:  Luciana  Haddad  
 
Reviewer's report:  
This is a retrospective study to analy ze if continuous suturing with two anterior layers reduces 
post-operative complications and hospitalization time in pancreaticoenterostomy. Unfortunately, 
this study has many shortcomings that need to be addressed and include the following:  
1- It is a retr ospective study, with data taken from medical records, with all the associated 
biases  
2- The groups were not randomized or paired. The fact that the two techniques were performed 
in different periods can also lead to biases, as it can occur other developm ents treatments 
and conduct at the time.  
3. The number of patients is small  
4- The significant difference found between the 2 groups was when compared the sum of 
complications. In most cases, the complications found in the group "suturing Interrupt" 
occurr ed in the same group of patients. There were no differences specifically in relation to 
the occurrence of pancreatic fistula  
5- The studies by pancreatectomy techniques are difficult accomplishment, since they are 
rarely performed prospectively, randomized  study with a large number of participants. Thus, 
it is difficult to conclude in relation to the prevention of occurrence of pancreatic fistula and 
other complications.  
 
I suggest that the work is focused on the report of a new technique, if that is the ca se, not a 
comparative study.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments  to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the fo llowing questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content o f the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any  non-financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare that I  have no competing interests  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload  will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title : Continuous suturing with two anterior layers reduces p ost-operative complications and 
hospitalization time in pancreaticoenterostomy  
 
Version:  0 Date : 11 Jan 2016  
 
Reviewer:  Luciana  Haddad  
 
Reviewer's report:  
This is a retrospective study to analy ze if continuous suturing with two anterior layers reduces 
post-operative complications and hospitalization time in pancreaticoenterostomy. Unfortunately, 
this study has many shortcomings that need to be addressed and include the following:  
1- It is a retr ospective study, with data taken from medical records, with all the associated 
biases  
2- The groups were not randomized or paired. The fact that the two techniques were performed 
in different periods can also lead to biases, as it can occur other developm ents treatments 
and conduct at the time.  
3. The number of patients is small  
4- The significant difference found between the 2 groups was when compared the sum of 
complications. In most cases, the complications found in the group "suturing Interrupt" 
occurr ed in the same group of patients. There were no differences specifically in relation to 
the occurrence of pancreatic fistula  
5- The studies by pancreatectomy techniques are difficult accomplishment, since they are 
rarely performed prospectively, randomized  study with a large number of participants. Thus, 
it is difficult to conclude in relation to the prevention of occurrence of pancreatic fistula and 
other complications.  
 
I suggest that the work is focused on the report of a new technique, if that is the ca se, not a 
comparative study.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments  to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the fo llowing questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content o f the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any  non-financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
I declare that I  have no competing interests  
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload  will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
assistant