The second edition of this atlas focuses on imaging methods and techniques, new diagnostic concepts and therapeutic approaches in management of pancreatic neoplasms. Although interest in pancreatic pathology is very high in the radiological and gastroenterological communities, less is known about it than about, for example, liver pathology. Diagnosis depends on the structure of the pancreatic lesion, which can be directly visualized in US, CT or MR images. The book's focus is very much on the imaging and pathological appearances, with most of the text concentrated at the beginning of the book followed by images gallery. A comprehensive overview is provided of typical and atypical presentations and diverse aspects of common and rare pancreatic tumors, including ductal adenocarcinomas with dedicated chapter to ductal adenocarcinoma downstaging, neuroendocrine neoplasms, cystic pancreatic neoplasms and intraductal papillary mucinous neoplasms. The Verona "Pancreas Centre," the first institute of its kind in Italy and one of very few in the world, pursues an interdisciplinary approach to treating the problems of this organ, focusing on the patient, on research, and on teaching. A dedicated center that can look back on 40 years of tradition, many of its respected specialists have made essential contributions in surgery, gastroenterology, oncology, pathology, and radiology. Given its scope, this atlas will be an invaluable asset, helping radiologists understand the underlying pathology and helping pancreatic pathologists understand the imaging translation.

Uncommon tumors of the pancreas are of increasing interest for clinicians: cross imaging techniques development makes it possible to detect small lesions in the pancreatic gland of asymptomatic patients, and in the last decades a more detailed and specific pathological classification definitivelyopened an unexpected world of more or less rare pancreatic tumors. As a matter of fact, nowadays most surgical procedures deal with these so called uncommon pancreatic tumors such as cystic, endocrine and others unfrequent histotypes, and many patientsexperiencing an accidental discovery of this type of tumor need therefore a specialistic evaluation. The concept behind this volume is the need to give the correct clinical relevance to these "uncommon" tumors, that are ranked at the first place among pancreatic tumors, and that are definitively curable with a multimodal approach. Aim of the book is therefore to get clinicians closer to these pathologies, describing their complexity and the current state of the art in diagnostic, therapeutic and pathological classification strategy, thus providing them with the tools for a modern and updated clinical management of these patients.

This volume is a compendium of the lectures, presentations, and workshops of the International Congress entitled "Facing the Pancreatic Dilemma" and of the 17th Meeting of the Italian Association for the Study of the Pancreas, held in Verona on 16 -19 June 1993. Pancreatology is still a relatively young science. Many pathophysiological aspects of pancreatic disease are as yet obscure, and a fair number of the etio pathogenetic mechanisms adduced are no more than hypothetical. We have therefore chosen to compare and contrast in a single volume the various hypo theses and interpretations put forward by leading experts in the field. In view of the swift evolution of this branch of medical science, it is sound policy to bear in mind that yesterday's heresies have become today's orthodoxy, and that todays's heresies may well turn out to be accepted orthodoxy in a not too distant future. The various "pancreatic dilemmas" are addressed systematically in these pages, and we believe that the book will prove an invaluable tool for the special ist and for any physician dealing with pancreatic disease. The book also represents a tribute by the Verona School of Pancreatology to the memory of Prof. L. A. Scuro, founder of the School and one of the outstanding Italian pioneers of pancreatology."

Introducing this monograph by expressing our heartfeIt thanks to all those who have contributed to its success may seem no more than a rhetorical exercise. However, at the same time we feel duty bound to add our sincere apologies, for we know that many of the dis tinguished authors of the various chapters have been hard put to find any relevant information in the existing literature. The plain fact is that very little has been said and written about pancreatic fistulas compared with other aspects of pancreatic disease. Why is this? Essentially, we believe there may be two main reasons: one practical explanation may be their relative rarity, while the other reas on is, as it were, "psychological," i. e., pancreatic fistulas tend almost invariably to be regarded as complications of an imperfectly performed surgical procedure. However useful it might be if we were to do it more often, it goes against the grain to public1y admit one's own mistakes. Ever since I (P. P. ) started practising in medicine, it has been my destiny and privilege to work alongside Professor Dagradi, the pioneer ofpancreatic surgeryin Italy, and to assist him over the years in something like 2000 operations on the pancreatic gland. Clearly, then, any complication due or related to such surgery however rare, has become part and parcel of my practical day-to-day c1inical experience and scientific interests."

The increasing incidence of both chronic pancreatitis and pan creatic cancer was the primary impetus for the organization of this meeting, an additional factor being the widespread existence of pancreatic disease within Italy itself. It is well known that the treatment of chronic and particularly of acute pancreatitis is still a matter of controversy, and it seemed useful to compare our own experience with that of other centers working in the same field. Consequently, in addition to numerous Italian specialists in the field, doctors from the Federal Republic of Germany, Denmark, Great Britain, France, and Austria were invited to attend the meeting. The symposium lasted two days and comprised eight sessions dealing with the anatomy and physiology of the pancreas and the pathophysiology, diagnosis, and treatment of pancreatic diseases. A central feature of the discussion on the surgical treatment of chronic pancreatitis was the debate between those who favor the use of drainage and those who believe resection to be the best treatment. Finally, I would like to thank Dr. Cavallini and Dr. Pederzoli very much for their help in organizing the meeting and also the local authorities for their aid. Professor Adamo Dagradi Director of the Institute of Clinica Chirurgica, Verona Opening Address I am pleased to welcome all partlclpants and particularly the guests from abroad, to this meeting on the clinical evaluation of pancreatitis."

Uncommon tumors of the pancreas are of increasing interest for clinicians: cross imaging techniques development makes it possible to detect small lesions in the pancreatic gland of asymptomatic patients, and in the last decades a more detailed and specific pathological classification definitivelyopened an unexpected world of more or less rare pancreatic tumors. As a matter of fact, nowadays most surgical procedures deal with these so called uncommon pancreatic tumors such as cystic, endocrine and others unfrequent histotypes, and many patientsexperiencing an accidental discovery of this type of tumor need therefore a specialistic evaluation. The concept behind this volume is the need to give the correct clinical relevance to these "uncommon" tumors, that are ranked at the first place among pancreatic tumors, and that are definitively curable with a multimodal approach. Aim of the book is therefore to get clinicians closer to these pathologies, describing their complexity and the current state of the art in diagnostic, therapeutic and pathological classification strategy, thus providing them with the tools for a modern and updated clinical management of these patients.