Title: Ligation of Left Gastric Vein May Cause Delayed Gastric Emptying After
Pancreatoduodenectomy: A Retrospective Study
Version: 1 Date: 16 Jun 2022
Reviewer's report:
This is an interesting retrospective study of 105 patients who underwent SSPPD, discussing
postoperative complications from the vascular anatomy. The focus on the relationship between
LGV preservation and DGE is a novel perspective. However, there are some questions about the
method and evaluation. Since LGV ligation can be dependent on vascular anatomy and tumor
factors, the risk factor for DGE development may not be LGV ligation but those factors.
#1. Although many general results such as surgical procedure or postoperative complication are
described, since the purpose of this paper is the relationship between DGE and LGV, it would
have more impact if DGE and LGV were described in more detail.
#2. How do they decide whether or not to ligate the LGV? We assume that the ligation of the
LGV is dictated by the extent of dissection and the progression of the cancer as well as the
vascular running, but is it a surgeon's preference? No mention is made of tumor size, invasion
of organs or blood vessels, or stage of cancer.
#3. Is the running pattern of LGV classification appropriate? Since the authors focus on ligation
of the LGV, an anatomical classification based on the need for ligation of the LGV would be
better. In order to perform #8 lymph node dissection, the LGV running around the CHA is
considered to be resected, while the LGV running around the SpA is not. In addition, there is a
type of LGV that flows into the left branch of the portal vein, but it has not been classified.
#4. Table 4 does not include author’s LGV classification.
#5. Since there are many supplementary tables, it is desirable to summarize the data in the
original tables.
# Authors detected running patter of LGV using computed tomography performed before
surgery and intraoperative findings from operation records. It is advisable to describe the
preoperative and intraoperative findings of the LGV running, respectively.
# How often is octreotide administration given?
# The analysis method in Table 5 is not described, is it logistic regression?
Title: Ligation of Left Gastric Vein May Cause Delayed Gastric Emptying After
Pancreatoduodenectomy: A Retrospective Study
Version: 1 Date: 16 Jun 2022
Reviewer's report:
This is an interesting retrospective study of 105 patients who underwent SSPPD, discussing
postoperative complications from the vascular anatomy. The focus on the relationship between
LGV preservation and DGE is a novel perspective. However, there are some questions about the
method and evaluation. Since LGV ligation can be dependent on vascular anatomy and tumor
factors, the risk factor for DGE development may not be LGV ligation but those factors.
#1. Although many general results such as surgical procedure or postoperative complication are
described, since the purpose of this paper is the relationship between DGE and LGV, it would
have more impact if DGE and LGV were described in more detail.
#2. How do they decide whether or not to ligate the LGV? We assume that the ligation of the
LGV is dictated by the extent of dissection and the progression of the cancer as well as the
vascular running, but is it a surgeon's preference? No mention is made of tumor size, invasion
of organs or blood vessels, or stage of cancer.
#3. Is the running pattern of LGV classification appropriate? Since the authors focus on ligation
of the LGV, an anatomical classification based on the need for ligation of the LGV would be
better. In order to perform #8 lymph node dissection, the LGV running around the CHA is
considered to be resected, while the LGV running around the SpA is not. In addition, there is a
type of LGV that flows into the left branch of the portal vein, but it has not been classified.
#4. Table 4 does not include author’s LGV classification.
#5. Since there are many supplementary tables, it is desirable to summarize the data in the
original tables.
# Authors detected running patter of LGV using computed tomography performed before
surgery and intraoperative findings from operation records. It is advisable to describe the
preoperative and intraoperative findings of the LGV running, respectively.
# How often is octreotide administration given?
# The analysis method in Table 5 is not described, is it logistic regression?
Please review this paper.
user
Title: Ligation of Left Gastric Vein May Cause Delayed Gastric Emptying After
Pancreatoduodenectomy: A Retrospective Study
Version: 1 Date: 16 Jun 2022
Reviewer's report:
This is an interesting retrospective study of 105 patients who underwent SSPPD, discussing
postoperative complications from the vascular anatomy. The focus on the relationship between
LGV preservation and DGE is a novel perspective. However, there are some questions about the
method and evaluation. Since LGV ligation can be dependent on vascular anatomy and tumor
factors, the risk factor for DGE development may not be LGV ligation but those factors.
#1. Although many general results such as surgical procedure or postoperative complication are
described, since the purpose of this paper is the relationship between DGE and LGV, it would
have more impact if DGE and LGV were described in more detail.
#2. How do they decide whether or not to ligate the LGV? We assume that the ligation of the
LGV is dictated by the extent of dissection and the progression of the cancer as well as the
vascular running, but is it a surgeon's preference? No mention is made of tumor size, invasion
of organs or blood vessels, or stage of cancer.
#3. Is the running pattern of LGV classification appropriate? Since the authors focus on ligation
of the LGV, an anatomical classification based on the need for ligation of the LGV would be
better. In order to perform #8 lymph node dissection, the LGV running around the CHA is
considered to be resected, while the LGV running around the SpA is not. In addition, there is a
type of LGV that flows into the left branch of the portal vein, but it has not been classified.
#4. Table 4 does not include author’s LGV classification.
#5. Since there are many supplementary tables, it is desirable to summarize the data in the
original tables.
# Authors detected running patter of LGV using computed tomography performed before
surgery and intraoperative findings from operation records. It is advisable to describe the
preoperative and intraoperative findings of the LGV running, respectively.
# How often is octreotide administration given?
# The analysis method in Table 5 is not described, is it logistic regression?
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