Reviewer’s report
Title: 
Situs inversus totalis with local metastasis of gallbladder carcinoma and
variation of the common hepatic artery: a case report
Version: 
1 
Date: 
27 Mar 2022
Reviewer: 
Firdaus Hayati
Reviewer's report:
Title
Authors
Authors are from the qualified and relevant fields of hepatobiliary surgery.
There are no radiologist or anatomic pathologist in this authorship team, yet they
can be acknowledged in the acknowledgement section. 
Abstract
Page 2, line 11: "Situs inversus totalis (SIT) is a rare abnormal complication", I
believe this is a rare congenital anomaly. It is not a sequelae of any acquired
condition. I suggest to change to rare congenital anomaly.
Page 2, line 12: "Most SIT cases occur concurrently with tumors", any reference
for this? This is an important fact.
Page 2, line 15: The term "jumping metastasis", is it a standard terminology? If it
is not, suggest to change the term.
Page 3, line 2,3: "Then, we 3 checked this patient with detailed examination and
treated with careful surgery", suggest to revise this sentence. It does not sound
scientific. I believe, this sentence "Then, we checked this patient with detailed
examination and treated with careful surgery" is unnecessary as it is a standard
procedure. Suggest to be economical in scientific writing.
Page 3, line 4,5: Suggest to reword the sentence, "…the presence of SIT,
gallbladder and pancreatic tail tumor and a variation of the common hepatic
artery (CHA)". It does not appear to be scientific merit in portraying a diagnosis
of concomitant tumors of gallbladder and pancreas in the presence of SIT.
Page 3, line 7,8: Any medical term for these procedures, "radical
cholecystectomy, complete pancreas, duodenum and spleen resection as well as
hepatic artery-splenic artery reconstruction."? Suggest "radical cholecystectomy,
total pancreatectomy, splenectomy and hepatic artery-splenic artery
reconstruction."
Page 3, line 9: Suggest to change "Further analyses" to "Histological analyses"
revealed metastasis of the gallbladder carcinoma into the pancreas. 
Page 3, line 13-15: Conclusion does not reflect the current case presentation.
Kindly revise. 
Keywords
Must follow MeSH Browser. Suggest to orientate according to the alphabetical
orders.
Background
SIT needs thorough preoperative imaging of the involved organs such as the
biliary system and periportal vasculature. It is not only challenging in malignant
cases, yet benign cases as well. Meticulous dissection technique and a consistent
awareness regarding the mirrored orientation is crucial to avoid any unnecessary
complications. 
Suggested references if the authors think they are important and beneficial.
Gan DEY, Alagoo D, Chan KH, Choi RXY, Sellappan H, Sharif MS, et al.
Choledochal cyst and aberrant biliary configuration along with situs inversus
totalis: a case report. Pan African Medical Journal. 2021;38:398
Che Ani MF, Ismail MAT, Abdul Rashid NF, Hayati F. Concurrent hollow and
visceral organs traumatic injury secondary to metal shrapnel penetration in a
male with situs inversus totalis: A case report. Trauma Case Rep.
2022;38:100626
Page 4, line 13: the words "rid of" is improper. Suggest to change to the word
"avoid"
Case presentation
Page 5, line 4: Suggest to include other important findings especially clinical
examination and biochemical investigations. Certain importation information
such as cachexia, jaundice, abdominal mass, obstructive jaundice from liver
function test deserve to be highlighted even they were negative. 
Page 5, line 7: "had moved" meaning that it was located at the normal position
initially. Suggest to revise. 
Page 5, line 12-14: I am not sure whether the history of detailed family members
undergoing screening for CT is crucial or not, but in this case it is rarely
valuable. Unless, we are referring to familial disease such as FAP or MTC etc.
Suggest to remove, unless the authors can justify.
Page 6: Certain situation, using a passive voice appears more scientific rather
than active voice sentences. 
Page 7, line 5: Any justification of pancreatic cancer metastasis, not just a
synchronous double cancer?
Mori H, Iida H, Maehira H, Kitamura N, Shimizu T, Tani M. Synchronous
primary gallbladder and pancreatic cancer associated with congenital biliary
dilatation and pancreaticobiliary maljunction. Surg Case Rep. 2017;3(1):113. 
Page 8, line 2-5: it is good to highlight on the possibility of postoperative
complications and subsequent progress.
Discussion
Page 8, line 10,11: The authors also stated that there is no familial involvement
in SIT.
Page 8, line 15,16: I agree that this is the first paper to highlight that. There is no
other case in during literature search.
Page 9, line 3,4: I totally agree with the sentence on the importance of
preoperative imaging studies and diagnosis.
Page 9, line 13,14: I totally agree with the sentence on implication of wrong
judgement.
The discussion had discussed very well on the anatomical anomalies.
Conclusion
The given conclusion is as in general situation, but readers want to know what
will be the take-home message from this case alone. Kindly revise that.
Acknowledgement
Page 15, line 9-12: Suggest to acknowledge the radiology and anatomic
pathology team members.
Table 1
It is nicely aligned according to the year of occurrence.
Figure 1
The figure of liver, biliary, duodenum, IVC and aorta - please kindly get the
approval of using the figures. They are subjected to the copyright issue, unless
the figures were drawn personally by the authors.
Suggest to provide individual figures rather than many figures in 1 picture. The
figures must have a magnification of 300 dpi min with 10 cm shortest length.
This is to ensure the high quality of the produced figures.
Figure 1D and 1E - the H&E magnification were not stated. The given histology
figures are very blur and not well visualised.
Any images of immunohistochemistry?
Thank you. 
Publons Reviewer Recognition
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Yes
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 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 of 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
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Reviewer’s report
Title: 
Situs inversus totalis with local metastasis of gallbladder carcinoma and
variation of the common hepatic artery: a case report
Version: 
1 
Date: 
27 Mar 2022
Reviewer: 
Firdaus Hayati
Reviewer's report:
Title
Authors
Authors are from the qualified and relevant fields of hepatobiliary surgery.
There are no radiologist or anatomic pathologist in this authorship team, yet they
can be acknowledged in the acknowledgement section. 
Abstract
Page 2, line 11: "Situs inversus totalis (SIT) is a rare abnormal complication", I
believe this is a rare congenital anomaly. It is not a sequelae of any acquired
condition. I suggest to change to rare congenital anomaly.
Page 2, line 12: "Most SIT cases occur concurrently with tumors", any reference
for this? This is an important fact.
Page 2, line 15: The term "jumping metastasis", is it a standard terminology? If it
is not, suggest to change the term.
Page 3, line 2,3: "Then, we 3 checked this patient with detailed examination and
treated with careful surgery", suggest to revise this sentence. It does not sound
scientific. I believe, this sentence "Then, we checked this patient with detailed
examination and treated with careful surgery" is unnecessary as it is a standard
procedure. Suggest to be economical in scientific writing.
Page 3, line 4,5: Suggest to reword the sentence, "…the presence of SIT,
gallbladder and pancreatic tail tumor and a variation of the common hepatic
artery (CHA)". It does not appear to be scientific merit in portraying a diagnosis
of concomitant tumors of gallbladder and pancreas in the presence of SIT.
Page 3, line 7,8: Any medical term for these procedures, "radical
cholecystectomy, complete pancreas, duodenum and spleen resection as well as
hepatic artery-splenic artery reconstruction."? Suggest "radical cholecystectomy,
total pancreatectomy, splenectomy and hepatic artery-splenic artery
reconstruction."
Page 3, line 9: Suggest to change "Further analyses" to "Histological analyses"
revealed metastasis of the gallbladder carcinoma into the pancreas. 
Page 3, line 13-15: Conclusion does not reflect the current case presentation.
Kindly revise. 
Keywords
Must follow MeSH Browser. Suggest to orientate according to the alphabetical
orders.
Background
SIT needs thorough preoperative imaging of the involved organs such as the
biliary system and periportal vasculature. It is not only challenging in malignant
cases, yet benign cases as well. Meticulous dissection technique and a consistent
awareness regarding the mirrored orientation is crucial to avoid any unnecessary
complications. 
Suggested references if the authors think they are important and beneficial.
Gan DEY, Alagoo D, Chan KH, Choi RXY, Sellappan H, Sharif MS, et al.
Choledochal cyst and aberrant biliary configuration along with situs inversus
totalis: a case report. Pan African Medical Journal. 2021;38:398
Che Ani MF, Ismail MAT, Abdul Rashid NF, Hayati F. Concurrent hollow and
visceral organs traumatic injury secondary to metal shrapnel penetration in a
male with situs inversus totalis: A case report. Trauma Case Rep.
2022;38:100626
Page 4, line 13: the words "rid of" is improper. Suggest to change to the word
"avoid"
Case presentation
Page 5, line 4: Suggest to include other important findings especially clinical
examination and biochemical investigations. Certain importation information
such as cachexia, jaundice, abdominal mass, obstructive jaundice from liver
function test deserve to be highlighted even they were negative. 
Page 5, line 7: "had moved" meaning that it was located at the normal position
initially. Suggest to revise. 
Page 5, line 12-14: I am not sure whether the history of detailed family members
undergoing screening for CT is crucial or not, but in this case it is rarely
valuable. Unless, we are referring to familial disease such as FAP or MTC etc.
Suggest to remove, unless the authors can justify.
Page 6: Certain situation, using a passive voice appears more scientific rather
than active voice sentences. 
Page 7, line 5: Any justification of pancreatic cancer metastasis, not just a
synchronous double cancer?
Mori H, Iida H, Maehira H, Kitamura N, Shimizu T, Tani M. Synchronous
primary gallbladder and pancreatic cancer associated with congenital biliary
dilatation and pancreaticobiliary maljunction. Surg Case Rep. 2017;3(1):113. 
Page 8, line 2-5: it is good to highlight on the possibility of postoperative
complications and subsequent progress.
Discussion
Page 8, line 10,11: The authors also stated that there is no familial involvement
in SIT.
Page 8, line 15,16: I agree that this is the first paper to highlight that. There is no
other case in during literature search.
Page 9, line 3,4: I totally agree with the sentence on the importance of
preoperative imaging studies and diagnosis.
Page 9, line 13,14: I totally agree with the sentence on implication of wrong
judgement.
The discussion had discussed very well on the anatomical anomalies.
Conclusion
The given conclusion is as in general situation, but readers want to know what
will be the take-home message from this case alone. Kindly revise that.
Acknowledgement
Page 15, line 9-12: Suggest to acknowledge the radiology and anatomic
pathology team members.
Table 1
It is nicely aligned according to the year of occurrence.
Figure 1
The figure of liver, biliary, duodenum, IVC and aorta - please kindly get the
approval of using the figures. They are subjected to the copyright issue, unless
the figures were drawn personally by the authors.
Suggest to provide individual figures rather than many figures in 1 picture. The
figures must have a magnification of 300 dpi min with 10 cm shortest length.
This is to ensure the high quality of the produced figures.
Figure 1D and 1E - the H&E magnification were not stated. The given histology
figures are very blur and not well visualised.
Any images of immunohistochemistry?
Thank you. 
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
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 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 of 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
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Please review this paper.
user
Reviewer’s report
Title: 
Situs inversus totalis with local metastasis of gallbladder carcinoma and
variation of the common hepatic artery: a case report
Version: 
1 
Date: 
27 Mar 2022
Reviewer: 
Firdaus Hayati
Reviewer's report:
Title
Authors
Authors are from the qualified and relevant fields of hepatobiliary surgery.
There are no radiologist or anatomic pathologist in this authorship team, yet they
can be acknowledged in the acknowledgement section. 
Abstract
Page 2, line 11: "Situs inversus totalis (SIT) is a rare abnormal complication", I
believe this is a rare congenital anomaly. It is not a sequelae of any acquired
condition. I suggest to change to rare congenital anomaly.
Page 2, line 12: "Most SIT cases occur concurrently with tumors", any reference
for this? This is an important fact.
Page 2, line 15: The term "jumping metastasis", is it a standard terminology? If it
is not, suggest to change the term.
Page 3, line 2,3: "Then, we 3 checked this patient with detailed examination and
treated with careful surgery", suggest to revise this sentence. It does not sound
scientific. I believe, this sentence "Then, we checked this patient with detailed
examination and treated with careful surgery" is unnecessary as it is a standard
procedure. Suggest to be economical in scientific writing.
Page 3, line 4,5: Suggest to reword the sentence, "…the presence of SIT,
gallbladder and pancreatic tail tumor and a variation of the common hepatic
artery (CHA)". It does not appear to be scientific merit in portraying a diagnosis
of concomitant tumors of gallbladder and pancreas in the presence of SIT.
Page 3, line 7,8: Any medical term for these procedures, "radical
cholecystectomy, complete pancreas, duodenum and spleen resection as well as
hepatic artery-splenic artery reconstruction."? Suggest "radical cholecystectomy,
total pancreatectomy, splenectomy and hepatic artery-splenic artery
reconstruction."
Page 3, line 9: Suggest to change "Further analyses" to "Histological analyses"
revealed metastasis of the gallbladder carcinoma into the pancreas. 
Page 3, line 13-15: Conclusion does not reflect the current case presentation.
Kindly revise. 
Keywords
Must follow MeSH Browser. Suggest to orientate according to the alphabetical
orders.
Background
SIT needs thorough preoperative imaging of the involved organs such as the
biliary system and periportal vasculature. It is not only challenging in malignant
cases, yet benign cases as well. Meticulous dissection technique and a consistent
awareness regarding the mirrored orientation is crucial to avoid any unnecessary
complications. 
Suggested references if the authors think they are important and beneficial.
Gan DEY, Alagoo D, Chan KH, Choi RXY, Sellappan H, Sharif MS, et al.
Choledochal cyst and aberrant biliary configuration along with situs inversus
totalis: a case report. Pan African Medical Journal. 2021;38:398
Che Ani MF, Ismail MAT, Abdul Rashid NF, Hayati F. Concurrent hollow and
visceral organs traumatic injury secondary to metal shrapnel penetration in a
male with situs inversus totalis: A case report. Trauma Case Rep.
2022;38:100626
Page 4, line 13: the words "rid of" is improper. Suggest to change to the word
"avoid"
Case presentation
Page 5, line 4: Suggest to include other important findings especially clinical
examination and biochemical investigations. Certain importation information
such as cachexia, jaundice, abdominal mass, obstructive jaundice from liver
function test deserve to be highlighted even they were negative. 
Page 5, line 7: "had moved" meaning that it was located at the normal position
initially. Suggest to revise. 
Page 5, line 12-14: I am not sure whether the history of detailed family members
undergoing screening for CT is crucial or not, but in this case it is rarely
valuable. Unless, we are referring to familial disease such as FAP or MTC etc.
Suggest to remove, unless the authors can justify.
Page 6: Certain situation, using a passive voice appears more scientific rather
than active voice sentences. 
Page 7, line 5: Any justification of pancreatic cancer metastasis, not just a
synchronous double cancer?
Mori H, Iida H, Maehira H, Kitamura N, Shimizu T, Tani M. Synchronous
primary gallbladder and pancreatic cancer associated with congenital biliary
dilatation and pancreaticobiliary maljunction. Surg Case Rep. 2017;3(1):113. 
Page 8, line 2-5: it is good to highlight on the possibility of postoperative
complications and subsequent progress.
Discussion
Page 8, line 10,11: The authors also stated that there is no familial involvement
in SIT.
Page 8, line 15,16: I agree that this is the first paper to highlight that. There is no
other case in during literature search.
Page 9, line 3,4: I totally agree with the sentence on the importance of
preoperative imaging studies and diagnosis.
Page 9, line 13,14: I totally agree with the sentence on implication of wrong
judgement.
The discussion had discussed very well on the anatomical anomalies.
Conclusion
The given conclusion is as in general situation, but readers want to know what
will be the take-home message from this case alone. Kindly revise that.
Acknowledgement
Page 15, line 9-12: Suggest to acknowledge the radiology and anatomic
pathology team members.
Table 1
It is nicely aligned according to the year of occurrence.
Figure 1
The figure of liver, biliary, duodenum, IVC and aorta - please kindly get the
approval of using the figures. They are subjected to the copyright issue, unless
the figures were drawn personally by the authors.
Suggest to provide individual figures rather than many figures in 1 picture. The
figures must have a magnification of 300 dpi min with 10 cm shortest length.
This is to ensure the high quality of the produced figures.
Figure 1D and 1E - the H&E magnification were not stated. The given histology
figures are very blur and not well visualised.
Any images of immunohistochemistry?
Thank you. 
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
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 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 of 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
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
assistant