Reviewer ’s report  
 
Title: Clinical practice of basin -shaped hepaticojejunostomy following hilar resection of stage 
III/IV hilar cholangiocarcinoma  
 
Version: 0 Date: 23 Feb 2018  
 
Reviewer: Dirk Stippel  
 
Reviewer's report:  
 
The manuscript describes a series of hilar resection of Bismuth IV Klatskin tumors. The overall 
results are very good and it is an impressive piece of surgical work. However the new scientific 
information is very limited, this is for the following reason:  
1) The surgical  technique described is not new, but has been used for more than 50 years.  
2) It is a retrospective, one arm, and observational study, there is no control group.  
3) "All patients underwent successful R0 high hilar resection". This is an extraordinary resul ts, 
however the authors do not give any information on lymphangiosis, haemangiosis, infiltration of 
the hilar fatty tissue or whether the patients were R0 concerning the perineural infiltration. 8/32 
patients had macroscopic portal vein infiltration and an other four patients macroscopic 
infiltration of the hepatic artery. It would be interesting to know the exact histopathological 
staging in these cases.  
4) The information on postoperative results is very limited. There is no information what kind of 
follow  up was performed.  
5) The introduction of "polyvinyl chloride tube as a stent" - as lost stent - is also not a new 
technique. In the discussion these stents are discussed as one of the major improvements. 
However in the manuscript it is not described how o ften these stent were used, whether there was 
an internal control group or what data there are to promote these stents.  
In conclusion it is an impressive series of local resection of hilar cancer. However the methods of 
the study, as described, were not ab le to create new information.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are requi red 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.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscrip t 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.  
 
Not relevant to this manuscript  
 
Quality of written Englis h 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements , fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
finan cially 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 of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organ ization 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 wi ll 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 wish 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: Clinical practice of basin -shaped hepaticojejunostomy following hilar resection of stage 
III/IV hilar cholangiocarcinoma  
 
Version: 0 Date: 23 Feb 2018  
 
Reviewer: Dirk Stippel  
 
Reviewer's report:  
 
The manuscript describes a series of hilar resection of Bismuth IV Klatskin tumors. The overall 
results are very good and it is an impressive piece of surgical work. However the new scientific 
information is very limited, this is for the following reason:  
1) The surgical  technique described is not new, but has been used for more than 50 years.  
2) It is a retrospective, one arm, and observational study, there is no control group.  
3) "All patients underwent successful R0 high hilar resection". This is an extraordinary resul ts, 
however the authors do not give any information on lymphangiosis, haemangiosis, infiltration of 
the hilar fatty tissue or whether the patients were R0 concerning the perineural infiltration. 8/32 
patients had macroscopic portal vein infiltration and an other four patients macroscopic 
infiltration of the hepatic artery. It would be interesting to know the exact histopathological 
staging in these cases.  
4) The information on postoperative results is very limited. There is no information what kind of 
follow  up was performed.  
5) The introduction of "polyvinyl chloride tube as a stent" - as lost stent - is also not a new 
technique. In the discussion these stents are discussed as one of the major improvements. 
However in the manuscript it is not described how o ften these stent were used, whether there was 
an internal control group or what data there are to promote these stents.  
In conclusion it is an impressive series of local resection of hilar cancer. However the methods of 
the study, as described, were not ab le to create new information.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are requi red 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.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscrip t 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.  
 
Not relevant to this manuscript  
 
Quality of written Englis h 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements , fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
finan cially 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 of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organ ization 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 wi ll 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 wish 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: Clinical practice of basin -shaped hepaticojejunostomy following hilar resection of stage 
III/IV hilar cholangiocarcinoma  
 
Version: 0 Date: 23 Feb 2018  
 
Reviewer: Dirk Stippel  
 
Reviewer's report:  
 
The manuscript describes a series of hilar resection of Bismuth IV Klatskin tumors. The overall 
results are very good and it is an impressive piece of surgical work. However the new scientific 
information is very limited, this is for the following reason:  
1) The surgical  technique described is not new, but has been used for more than 50 years.  
2) It is a retrospective, one arm, and observational study, there is no control group.  
3) "All patients underwent successful R0 high hilar resection". This is an extraordinary resul ts, 
however the authors do not give any information on lymphangiosis, haemangiosis, infiltration of 
the hilar fatty tissue or whether the patients were R0 concerning the perineural infiltration. 8/32 
patients had macroscopic portal vein infiltration and an other four patients macroscopic 
infiltration of the hepatic artery. It would be interesting to know the exact histopathological 
staging in these cases.  
4) The information on postoperative results is very limited. There is no information what kind of 
follow  up was performed.  
5) The introduction of "polyvinyl chloride tube as a stent" - as lost stent - is also not a new 
technique. In the discussion these stents are discussed as one of the major improvements. 
However in the manuscript it is not described how o ften these stent were used, whether there was 
an internal control group or what data there are to promote these stents.  
In conclusion it is an impressive series of local resection of hilar cancer. However the methods of 
the study, as described, were not ab le to create new information.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are requi red 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.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscrip t 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.  
 
Not relevant to this manuscript  
 
Quality of written Englis h 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements , fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
finan cially 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 of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organ ization 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 wi ll 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 wish 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