256 HEPAT 0:153 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Journal of Hepatology, 1992; 15: 256-261 (Q 1992 Elsevier Science Publishers B.V. All rights reserved. 0168-8278/92/$05.00 Consensus Report Definitions, methodology and therapeutic strategies in hypertension __ A Consensus Development Workshop’, Baveno, Lake Ma&ore, Italy, April 5 and 6,199O R. de Franchis=, J.P. Pascalb, E. Anconac, A.K. Burroughsd, M. Hendersone, W. Fkigf, R. Groszmanng, J. Boschh, T. Sauerbruch’, C. Soederlundj, D. Lebreck, T.I.A. Soerensen’ and L. Pagliaro” ‘Istituto di Medicina Interna, University of Milan, Milan, Italy (W orkshop Coordinator, ScientificSecretary of the W orkshop), zyxwvutsrqponmlk ‘Service d’Ht!patogastroent&ologie, C. H. II. Purpan, Toulouse, France (Chairman, Session I), ‘Istituto di Semeiotica Chirurgica, Universityof Padua. Padua, ItaIy (Chairman, Session 2), “Academic Department of Medicine, The Royal Free HospEtaI, London, United Kingdom (Chairman, Session 31, eDepurtment of Surgery, Emory University Hospital, Atlanta, GA, United States of America (Chairman, Session 4), fM edieinische Universitiitsklinik, Erlangen, Germany (Chairman, Session S), =HepaticHemodynamic Laboratory, Yale University School of M edicine, W est Haven, CT United States of America (Chairman, Session 6), hUnidad de Hepatologia, Hospital Clinic i Provincial, Barcelona, Spain (Chairman Session, 7), ‘KIinikum Grosshadern, Medizinische Klinik II, Munich, Germany (Chairman, Session 8a), ‘Ifeparttnent of General Surgery, Soder Hospital, Karolinska Instituter, Stockholm, Sweden (Chairman, Session 86), kUnitP de Recherches de Physiopathoiogie HPpatique, HSpital Beaujon, Clichy, France (Chairman, Session 8c), ‘Department of Medicine B 233, Hvidovre University Hospital, Copenhagen, Denmark (Chairman, Session 9) and “Istituto di Clinica Medica (R)* Ospedale V, Cervello, University of Palermo, PaIermo, Italy (Chairman, Session 10). - _ __ ____ Over the last decade, diagnostic and therapeutic ap- preventing first bleeding and rebleeding are still poorly proaches to portal hypertension have changed dramati- defined. Three main reasons account for this: firs;, va- cally. On the diagnostic side, endoscopy, hemodynamic riceal bleeding is a medical emergency, which makes the studies and imaging techniques (including Doppler ultra- design and conduct of good trials difficult. Second, treat- sound) have greatly expanded our ability to study the ment of variceal hemorrhage does not treat cirrhosis liver and portal circulation. On the therapeutic side, the itself. Therefore, the outcome of trials aimed at treating introduction of vasoactive drugs and the re-discovery of acute variceal hemorrhage, or preventing first bleeding endoscopic sclerotherapy have changed the management or rebleeding, is heavily influenced by the severity of the of variceal hemorrhage. A number of randomized con- underlying liver disease. Third, many studies differ trolled trials have been carried out to test several treat- greatly, especially in the way information about patients ment modalities in different clinical settings. As a result and methods used is reported. This makes interpreting the role of surgery, which once was the cornerstone of the results and placing them in the context of previous treatment, is now markedly reduced. work difficult. Nevertheless, the value of the available diagnostic tools and the precise role of the various therapeutic mo- dalities in managing acute variceal hemorrhage and in For these reasons further progress can only be made if uniform nomenclature and consensus definitions are adopted, and if common guidelines are followed in de- Correspondence: Roberto de Franchis, M.D., Gastroenterology Service, Istituto di Medicina Interna, Via Pace 9, 20122 Milan, Italy. Requests for reprints snd for copies of the Baveno questionnaire should also be addressed to Dr. Roberto de Franchis. ‘Besides the Chairmen, participants in the discussion were: P. Alexandrino (Lisbon), R. Arcidiacono (Milan), G. Battaglia (Padua). L. Bolondi (Bologna), P. Cales (Toulouse), L. Cestari (Brcscia), F. Cosentino (Milan), M. Curzio (Varese). G. D’Amico (Palermo), P. Gertsch (Bern), G. Gerunda (Padua), G. Krejs (Graz), A. Maffei Faccioli (Padua), G. Minoli (Como), S. Moeller (Copenhagen), F. Nevens (Leuven), G. Pomier-Layrargues (Montreal), M. Primignani (Milan), C. Sabba (Bari). G. Spina (Milan), M. Star&z (Mainz), F. Tini (Palermo), H.R. van Buuren (Rotterdam), D. Westaby (London), V. Ziparo (Rome).