Reviewer ’s report  
 
Title: Jejunogastric intussusception after Whipple procedure w ith B -II Reconstruction: a case 
report  
 
Version: 0 Date: 06 Sep 2019  
 
Reviewer: Manabu Kawai  
 
Reviewer's report:  
 
This case report was written about jejunogastric intussusception after Whipple procedure. This 
manuscript states so me important issues regarding postoperative complications after Whipple 
procedure. However additional discussion would be required to confirm this conclusion. 
Therefore, authors would clarify several matters that mentioned below to confirm these 
conclusion s. 
 
1. Authors reported that jejunogastric intussusception occurred after Whipple procedure. 
As authors say, it might be difficult to clarify the etiology of jejunogastric 
intussusception. However, were there some problems during reconstruction of Whipple 
procedure when looking back at reconstruction retrospectively? Moreover, afferent limb 
seems not to be dilated regardless of jejunogastric intussusception of efferent limb. Could 
authors show the figure for reconstruction of Whipple procedure with Roux -en Y 
reconstruction: at first stage and discuss about reconstruction?  
 
2. Is jejunogastric intussusception associated with the size of anastomosis? In fig.2. 
jejunogastric anastomosis seems to be too wide. Could authors review any literatures 
about the correl ation between the size of anastomosis and jejunogastric intussusception?  
 
3. A case report about complications should be a guide and a lesson for someone who may 
experience the same complication. Unfortunately, some figures to show jejunogastric 
intussusce ption are poor. Could you add any figure of CT to understand jejunogastric 
intussusception well? Additionally, do authors have some pictures of intestinal loop after 
reducing the intussuscepted loop?  
 
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  manus cript or would you recommend an additional 
statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly 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 com peting 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 in cluded 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: Jejunogastric intussusception after Whipple procedure w ith B -II Reconstruction: a case 
report  
 
Version: 0 Date: 06 Sep 2019  
 
Reviewer: Manabu Kawai  
 
Reviewer's report:  
 
This case report was written about jejunogastric intussusception after Whipple procedure. This 
manuscript states so me important issues regarding postoperative complications after Whipple 
procedure. However additional discussion would be required to confirm this conclusion. 
Therefore, authors would clarify several matters that mentioned below to confirm these 
conclusion s. 
 
1. Authors reported that jejunogastric intussusception occurred after Whipple procedure. 
As authors say, it might be difficult to clarify the etiology of jejunogastric 
intussusception. However, were there some problems during reconstruction of Whipple 
procedure when looking back at reconstruction retrospectively? Moreover, afferent limb 
seems not to be dilated regardless of jejunogastric intussusception of efferent limb. Could 
authors show the figure for reconstruction of Whipple procedure with Roux -en Y 
reconstruction: at first stage and discuss about reconstruction?  
 
2. Is jejunogastric intussusception associated with the size of anastomosis? In fig.2. 
jejunogastric anastomosis seems to be too wide. Could authors review any literatures 
about the correl ation between the size of anastomosis and jejunogastric intussusception?  
 
3. A case report about complications should be a guide and a lesson for someone who may 
experience the same complication. Unfortunately, some figures to show jejunogastric 
intussusce ption are poor. Could you add any figure of CT to understand jejunogastric 
intussusception well? Additionally, do authors have some pictures of intestinal loop after 
reducing the intussuscepted loop?  
 
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  manus cript or would you recommend an additional 
statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly 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 com peting 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 in cluded 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: Jejunogastric intussusception after Whipple procedure w ith B -II Reconstruction: a case 
report  
 
Version: 0 Date: 06 Sep 2019  
 
Reviewer: Manabu Kawai  
 
Reviewer's report:  
 
This case report was written about jejunogastric intussusception after Whipple procedure. This 
manuscript states so me important issues regarding postoperative complications after Whipple 
procedure. However additional discussion would be required to confirm this conclusion. 
Therefore, authors would clarify several matters that mentioned below to confirm these 
conclusion s. 
 
1. Authors reported that jejunogastric intussusception occurred after Whipple procedure. 
As authors say, it might be difficult to clarify the etiology of jejunogastric 
intussusception. However, were there some problems during reconstruction of Whipple 
procedure when looking back at reconstruction retrospectively? Moreover, afferent limb 
seems not to be dilated regardless of jejunogastric intussusception of efferent limb. Could 
authors show the figure for reconstruction of Whipple procedure with Roux -en Y 
reconstruction: at first stage and discuss about reconstruction?  
 
2. Is jejunogastric intussusception associated with the size of anastomosis? In fig.2. 
jejunogastric anastomosis seems to be too wide. Could authors review any literatures 
about the correl ation between the size of anastomosis and jejunogastric intussusception?  
 
3. A case report about complications should be a guide and a lesson for someone who may 
experience the same complication. Unfortunately, some figures to show jejunogastric 
intussusce ption are poor. Could you add any figure of CT to understand jejunogastric 
intussusception well? Additionally, do authors have some pictures of intestinal loop after 
reducing the intussuscepted loop?  
 
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  manus cript or would you recommend an additional 
statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writ ten 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 reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly 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 com peting 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 understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 in cluded as confidential comments to the 
editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant