Reviewer ’s report  
 
Title: Expanding Laparoscopic Pancreaticoduodenectomy to Pancreatic -Head and Periampullary 
Malignancy: Major Findings Based on Systematic Review and Meta -analysis  
 
Version: 0 Date: 20 May 2018  
 
Reviewer: Giovanni Capretti  
 
Reviewer's report:  
 
First I want to thank you for the possibility to review your original work.  
The argument of minimally  invasive surgery is an hot topic and any work that could help in 
provide a better understanding of its role and value is relevant.  
Despite that I think your paper require some major revision before be suitable for publication:  
- In the abstract, methods section, you state that you are dealing with PDAC patients but in 
your paper you analyze also periampullary neoplasm. You should correct it  
 
- You starting pool of published papers is 668. Is a fair number for a review on a topic so 
specific and sectorial. All the same you should provide yours research strings to quell any 
doubts on the initial selection.  
 
- Among the works you analyze one single retrospectively work provide the vast majority of 
the cases. This is a major possible bias. I suggest you to perfo rm a sensitivity analysis to 
validated your findings.  
 
- Some publication had demonstrate that the R0 and lymph node retrieval could be related 
more to the definition and protocols followed during the hystopatological examination than 
to the surgical techni que or expertise. You should asses this problem in the discussion.  
 
- Due to the quality of the studies present in literature your results could be severely biases as 
you correctly state in the last part of the discussion. For this reason your data cannot s upport 
so strong conclusions. I suggest you to revise them.  
Best regards  
Are the methods appropriate and well described?  
If not, please specify what is required in  your comments to the authors.  
 
Yes 
  
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 additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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 public ation 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 curre ntly 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 g ive 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 repor t 
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: Expanding Laparoscopic Pancreaticoduodenectomy to Pancreatic -Head and Periampullary 
Malignancy: Major Findings Based on Systematic Review and Meta -analysis  
 
Version: 0 Date: 20 May 2018  
 
Reviewer: Giovanni Capretti  
 
Reviewer's report:  
 
First I want to thank you for the possibility to review your original work.  
The argument of minimally  invasive surgery is an hot topic and any work that could help in 
provide a better understanding of its role and value is relevant.  
Despite that I think your paper require some major revision before be suitable for publication:  
- In the abstract, methods section, you state that you are dealing with PDAC patients but in 
your paper you analyze also periampullary neoplasm. You should correct it  
 
- You starting pool of published papers is 668. Is a fair number for a review on a topic so 
specific and sectorial. All the same you should provide yours research strings to quell any 
doubts on the initial selection.  
 
- Among the works you analyze one single retrospectively work provide the vast majority of 
the cases. This is a major possible bias. I suggest you to perfo rm a sensitivity analysis to 
validated your findings.  
 
- Some publication had demonstrate that the R0 and lymph node retrieval could be related 
more to the definition and protocols followed during the hystopatological examination than 
to the surgical techni que or expertise. You should asses this problem in the discussion.  
 
- Due to the quality of the studies present in literature your results could be severely biases as 
you correctly state in the last part of the discussion. For this reason your data cannot s upport 
so strong conclusions. I suggest you to revise them.  
Best regards  
Are the methods appropriate and well described?  
If not, please specify what is required in  your comments to the authors.  
 
Yes 
  
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 additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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 public ation 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 curre ntly 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 g ive 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 repor t 
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: Expanding Laparoscopic Pancreaticoduodenectomy to Pancreatic -Head and Periampullary 
Malignancy: Major Findings Based on Systematic Review and Meta -analysis  
 
Version: 0 Date: 20 May 2018  
 
Reviewer: Giovanni Capretti  
 
Reviewer's report:  
 
First I want to thank you for the possibility to review your original work.  
The argument of minimally  invasive surgery is an hot topic and any work that could help in 
provide a better understanding of its role and value is relevant.  
Despite that I think your paper require some major revision before be suitable for publication:  
- In the abstract, methods section, you state that you are dealing with PDAC patients but in 
your paper you analyze also periampullary neoplasm. You should correct it  
 
- You starting pool of published papers is 668. Is a fair number for a review on a topic so 
specific and sectorial. All the same you should provide yours research strings to quell any 
doubts on the initial selection.  
 
- Among the works you analyze one single retrospectively work provide the vast majority of 
the cases. This is a major possible bias. I suggest you to perfo rm a sensitivity analysis to 
validated your findings.  
 
- Some publication had demonstrate that the R0 and lymph node retrieval could be related 
more to the definition and protocols followed during the hystopatological examination than 
to the surgical techni que or expertise. You should asses this problem in the discussion.  
 
- Due to the quality of the studies present in literature your results could be severely biases as 
you correctly state in the last part of the discussion. For this reason your data cannot s upport 
so strong conclusions. I suggest you to revise them.  
Best regards  
Are the methods appropriate and well described?  
If not, please specify what is required in  your comments to the authors.  
 
Yes 
  
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 additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
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 public ation 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 curre ntly 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 g ive 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 repor t 
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