Finally Throwing Those Wellies Away? Collaborating in Search of a Solution for Venice Flooding.

Collaborative governance is often advocated as a way to address 'messy' problems that individual stakeholders cannot solve alone. However, whereas stakeholders' participation brings a broad range of response options to public decision-making, the complexities of the perspectives at stake may also lead to conflicts and stalemates. This is especially true in collaborative environmental governance, where conflict is common and stakeholders' interdependence in more than one arena tends to be frequent.

[Ampullary and periampullary tumors].

Ninety-eight consecutive patients with ampullary and periampullary carcinoma diagnosed between 1983-1993 were studied retrospectively. Among these patients, 66 had a carcinoma of the head of the pancreas, 10 a carcinoma of the papilla of Vater, 8 a carcinoma of the duodenum, and 14 a carcinoma of the distal common bile duct. Resectability rate ranged from 12% to 90% according to the tumor location and histologic type.

[Cholecystosis: anatomo-clinical profile and therapeutic considerations].

In the last 5 years 16 patients with cholecystosis were observed. In this period the most recent diagnostic and therapeutic techniques were used including ultrasound which allowed to diagnose 60% of adenomyomatosis, 33.3% of cholecystosis and 6.

[Current trends in therapeutic indications in gallstones].

In the last 3 years, 300 consecutive patients (110 men, 190 women) were treated for gallstone disease using either traditional open surgery or the video laparoscopic approach. The relative clinical data and results were compared and analysed. The Authors conclude that video laparoscopy presents a number of advantages such as minor costs, reduced pain, quick return to work, compared to traditional surgery, especially when correctly indicated.

[The endoscopic treatment of postoperative stenoses of the upper digestive tract].

The authors compare their experience in dilatation of postoperative benign esophageal strictures. A total of 60 patients (37 males, 23 females: mean age 52), all with severe dysphagia, from January 1985 to September 1995, underwent endoscopic dilatation: 32 of these with Savary dilators and 28 with balloon dilators. Dilatation was effective in 93% in both groups.