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I have particular pleasure in introducing this publication by Gian
Pietro Marzoli and Sergio Vesentini. Years ago they
enthusiastically accepted my suggestion that they should take
specific interest in the clinical and surgical problem of portal
hypertension, and assess the proposals of surgical ex- perience
with regard to this debated physiopathological picture. These
thanks are all the more real because in this way the school's
attention remained fixed on a subject that had already attracted it
profoundly from the start - with Giovanni Castiglioni and Vittorio
Pettinari as heads of the school - and then threatened to die away
into general con- formism. In Italy "precariousness" is easily
extended to the concept of school continuity. In Warren's proposal
(1967) of "distal splenorenal anas- tomosis with disconnection of
the spleno-oesophageal from the mesenteric district", I felt there
was an intelligent at- tempt to solve all the basic problems,
albeit in different ways. An attempt, that is to say, at
alleviating the gastro- oesophageal circulation, thus avoiding*
haemorrhage, and at ensuring that the liver would maintain the
circulatory ef- ficiency with which it was still endowed. The
spleen was re- tained, but there was reason to think that, by
reducing blood stasis within its ambit, it would be possible to
manage or alleviate any hypersplenism: not an absurd hypothesis if
the Americans had sometimes noted in their material function- al
and even anatomical reversion of the splenopathy after a simple
portacaval shunt.
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."
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