Title: Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a
cross-sectional study
Version: 1 Date: 09 Jun 2022
Reviewer's report:
This manuscript titled “Anatomical pancreatic variants in intraductal papillary mucinous
neoplasm patients: a cross-sectional study” is intriguing and informative. Although the authors
showed an informative retrospective study where patients with intraductal papillary mucinous
neoplasm (IPMN) have meandering main pancreatic duct (MMPD) more often than those
without IPMN, there were some problems in this manuscript. Therefore, it still needs a
considerable revision to be acceptable for BMC gastroenterology. My suggestions are described
below:
1) In this study, imaging data interpretation was performed by only one radiologist, although
he or she is an experienced radiologist. Therefore, there is no objectiveness in this study. These
imaging data should be diagnosed at least two separate radiologists with sufficient experience.
2) Diagnostic criteria of meandering main pancreatic duct (MMPD) should be described clearly.
For example, when cystic lesion in the pancreatic head oppresses the main pancreatic duct
(MPD) which lead to shaped curved formation of the MPD, do the authors decided it be a
MMPD? It is necessary to explain it in more detail.
3) Location of cystic lesions in patients with IPMN should be shown in table. Furthermore, the
type of IPMN also should be shown.
4) Although the authors showed the association between N-shape MMPD and cystic mural
nodule, the important factor for risk of malignancy in IPMN is the size of mural nodule,
especially diameter #5mm is important. So, they should describe the size of mural nodule in
Table 4.
5) Why the authors compared MMPD and descending type of non-MMPD to calculate odds risk
of accompanying IPMN. They should also compare patients with MMPD and all non-MMPD
patients.
6) In Table 1, the number of each column is inconsistent. For instance, “Duct of Santrini” showed
percentage of Duct of Santrini in MPD variations and “Reverse-Z type” meant the number. They
should be unified.
7) Association file 1 could be removed. Instead, these factors should be described in text.
Title: Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a
cross-sectional study
Version: 1 Date: 09 Jun 2022
Reviewer's report:
This manuscript titled “Anatomical pancreatic variants in intraductal papillary mucinous
neoplasm patients: a cross-sectional study” is intriguing and informative. Although the authors
showed an informative retrospective study where patients with intraductal papillary mucinous
neoplasm (IPMN) have meandering main pancreatic duct (MMPD) more often than those
without IPMN, there were some problems in this manuscript. Therefore, it still needs a
considerable revision to be acceptable for BMC gastroenterology. My suggestions are described
below:
1) In this study, imaging data interpretation was performed by only one radiologist, although
he or she is an experienced radiologist. Therefore, there is no objectiveness in this study. These
imaging data should be diagnosed at least two separate radiologists with sufficient experience.
2) Diagnostic criteria of meandering main pancreatic duct (MMPD) should be described clearly.
For example, when cystic lesion in the pancreatic head oppresses the main pancreatic duct
(MPD) which lead to shaped curved formation of the MPD, do the authors decided it be a
MMPD? It is necessary to explain it in more detail.
3) Location of cystic lesions in patients with IPMN should be shown in table. Furthermore, the
type of IPMN also should be shown.
4) Although the authors showed the association between N-shape MMPD and cystic mural
nodule, the important factor for risk of malignancy in IPMN is the size of mural nodule,
especially diameter #5mm is important. So, they should describe the size of mural nodule in
Table 4.
5) Why the authors compared MMPD and descending type of non-MMPD to calculate odds risk
of accompanying IPMN. They should also compare patients with MMPD and all non-MMPD
patients.
6) In Table 1, the number of each column is inconsistent. For instance, “Duct of Santrini” showed
percentage of Duct of Santrini in MPD variations and “Reverse-Z type” meant the number. They
should be unified.
7) Association file 1 could be removed. Instead, these factors should be described in text.
Please review this paper.
user
Title: Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a
cross-sectional study
Version: 1 Date: 09 Jun 2022
Reviewer's report:
This manuscript titled “Anatomical pancreatic variants in intraductal papillary mucinous
neoplasm patients: a cross-sectional study” is intriguing and informative. Although the authors
showed an informative retrospective study where patients with intraductal papillary mucinous
neoplasm (IPMN) have meandering main pancreatic duct (MMPD) more often than those
without IPMN, there were some problems in this manuscript. Therefore, it still needs a
considerable revision to be acceptable for BMC gastroenterology. My suggestions are described
below:
1) In this study, imaging data interpretation was performed by only one radiologist, although
he or she is an experienced radiologist. Therefore, there is no objectiveness in this study. These
imaging data should be diagnosed at least two separate radiologists with sufficient experience.
2) Diagnostic criteria of meandering main pancreatic duct (MMPD) should be described clearly.
For example, when cystic lesion in the pancreatic head oppresses the main pancreatic duct
(MPD) which lead to shaped curved formation of the MPD, do the authors decided it be a
MMPD? It is necessary to explain it in more detail.
3) Location of cystic lesions in patients with IPMN should be shown in table. Furthermore, the
type of IPMN also should be shown.
4) Although the authors showed the association between N-shape MMPD and cystic mural
nodule, the important factor for risk of malignancy in IPMN is the size of mural nodule,
especially diameter #5mm is important. So, they should describe the size of mural nodule in
Table 4.
5) Why the authors compared MMPD and descending type of non-MMPD to calculate odds risk
of accompanying IPMN. They should also compare patients with MMPD and all non-MMPD
patients.
6) In Table 1, the number of each column is inconsistent. For instance, “Duct of Santrini” showed
percentage of Duct of Santrini in MPD variations and “Reverse-Z type” meant the number. They
should be unified.
7) Association file 1 could be removed. Instead, these factors should be described in text.
assistant