Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 07 Feb 2018 
 
Reviewer:  Manabu  Kawai  
 
Reviewer’s report:  
 
Authors described about Feasibility of portal or superior mesenteric vein resection and 
reconstruction by allogeneic vein for pancreatic head cancer. This manuscript clearly stated some 
important issues reg arding PV/SMV resection and reconstruction, however further analysis and 
discussion would be required to confirm this conclusion. Therefore, authors would clarify several 
matters that mentioned below to confirm these conclusions.  
 
1. I completely agree wit h the use of an interposed graft during PV/SMV reconstruction to 
avoid incidences of vascular tension after anastomosis, vascular stenosis, and anastomotic 
stricture. In this study, it is more important to compare allogeneic vein with an 
autologous graft a s an interposed graft to evaluate safety of allogeneic vein. Why was 
allogeneic vein used for an interposed graft? An autologous graft seems to be safer than 
allogeneic vein when infectious postoperative complications occur after 
pancreaticoduodenctomy. Wh at is advantage of allogeneic vein for an interposed graft 
compared to an autologous graft?  
 
2. Authors discussed that the advantage of allogeneic vein for reconstruction is to avoid 
incidences of vascular tension after anastomosis, vascular stenosis, anas tomotic stricture 
and diameter mismatch. However, authors didn't evaluate portal vein thrombosis after 
reconstruction as short -term outcomes. Authors could compare complications related to 
PV/SMV resection and reconstruction between two groups.  
 
3. Long -term outcomes regarding using allogeneic vein remain still unclear. Stenosis or 
thrombosis due to using allogeneic vein may occur during long -term follow -up compared 
with PV/SMV reconstruction without allogeneic vein. Authors could evaluate long -term 
outcome s of allogeneic vein after PV/SMV resection and reconstruction.  
 
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 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 addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
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 
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 cont ent 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 wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 07 Feb 2018 
 
Reviewer:  Manabu  Kawai  
 
Reviewer’s report:  
 
Authors described about Feasibility of portal or superior mesenteric vein resection and 
reconstruction by allogeneic vein for pancreatic head cancer. This manuscript clearly stated some 
important issues reg arding PV/SMV resection and reconstruction, however further analysis and 
discussion would be required to confirm this conclusion. Therefore, authors would clarify several 
matters that mentioned below to confirm these conclusions.  
 
1. I completely agree wit h the use of an interposed graft during PV/SMV reconstruction to 
avoid incidences of vascular tension after anastomosis, vascular stenosis, and anastomotic 
stricture. In this study, it is more important to compare allogeneic vein with an 
autologous graft a s an interposed graft to evaluate safety of allogeneic vein. Why was 
allogeneic vein used for an interposed graft? An autologous graft seems to be safer than 
allogeneic vein when infectious postoperative complications occur after 
pancreaticoduodenctomy. Wh at is advantage of allogeneic vein for an interposed graft 
compared to an autologous graft?  
 
2. Authors discussed that the advantage of allogeneic vein for reconstruction is to avoid 
incidences of vascular tension after anastomosis, vascular stenosis, anas tomotic stricture 
and diameter mismatch. However, authors didn't evaluate portal vein thrombosis after 
reconstruction as short -term outcomes. Authors could compare complications related to 
PV/SMV resection and reconstruction between two groups.  
 
3. Long -term outcomes regarding using allogeneic vein remain still unclear. Stenosis or 
thrombosis due to using allogeneic vein may occur during long -term follow -up compared 
with PV/SMV reconstruction without allogeneic vein. Authors could evaluate long -term 
outcome s of allogeneic vein after PV/SMV resection and reconstruction.  
 
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 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 addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
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 
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 cont ent 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 wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  Feasibility of portal or superior mesenteric vein resection and reconstruction by allogeneic 
vein for pancreatic head cancer —a case -control study  
 
Version: 0 Date: 07 Feb 2018 
 
Reviewer:  Manabu  Kawai  
 
Reviewer’s report:  
 
Authors described about Feasibility of portal or superior mesenteric vein resection and 
reconstruction by allogeneic vein for pancreatic head cancer. This manuscript clearly stated some 
important issues reg arding PV/SMV resection and reconstruction, however further analysis and 
discussion would be required to confirm this conclusion. Therefore, authors would clarify several 
matters that mentioned below to confirm these conclusions.  
 
1. I completely agree wit h the use of an interposed graft during PV/SMV reconstruction to 
avoid incidences of vascular tension after anastomosis, vascular stenosis, and anastomotic 
stricture. In this study, it is more important to compare allogeneic vein with an 
autologous graft a s an interposed graft to evaluate safety of allogeneic vein. Why was 
allogeneic vein used for an interposed graft? An autologous graft seems to be safer than 
allogeneic vein when infectious postoperative complications occur after 
pancreaticoduodenctomy. Wh at is advantage of allogeneic vein for an interposed graft 
compared to an autologous graft?  
 
2. Authors discussed that the advantage of allogeneic vein for reconstruction is to avoid 
incidences of vascular tension after anastomosis, vascular stenosis, anas tomotic stricture 
and diameter mismatch. However, authors didn't evaluate portal vein thrombosis after 
reconstruction as short -term outcomes. Authors could compare complications related to 
PV/SMV resection and reconstruction between two groups.  
 
3. Long -term outcomes regarding using allogeneic vein remain still unclear. Stenosis or 
thrombosis due to using allogeneic vein may occur during long -term follow -up compared 
with PV/SMV reconstruction without allogeneic vein. Authors could evaluate long -term 
outcome s of allogeneic vein after PV/SMV resection and reconstruction.  
 
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 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 addi tional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
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 
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 cont ent 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 wish to be included in my named report can be included as confidential comments 
to the editors, which will n ot be published.  
 
I agree to the open peer review policy of the journal  
assistant