Introduction: Laparoscopic cholecystectomy is the mainstay of treatment in symptomatic cholelithiasis. Surgeons are still following the old habit of routine Subhepatic drainage following laparoscopic cholecystectomy (LC). However, routine drainage after LC is still a debatable issue. This study aims at evaluating the effects of Subhepatic drainage after standard laparoscopic cholecystectomy in terms of various post-operative parameters. Materials & methods: The study was conducted at the department of General Surgery, ESIC-PGIMSR, Joka, Kolkata from January 2018 to March 2020. We selected 120 patients with symptomatic cholelithiasis & divided them into 2 groups; each having 60 patients, with drain & without drain respectively. Age & sex distribution of the patients, post-operative abdominal pain & right shoulder tip pain, post-operative wound infection, subhepatic collection (24 & 72 hrs after surgery) & post-surgical hospital stay were measured in both groups. Data were analyzed by appropriate statistical tests. Results: We found the incidence of laparoscopic cholecystectomy was highest in the 5th decade & more common in women. The incidence of post-surgical abdominal pain & subhepatic collection were greater in the group of patients with drain in situ which was statistically significant also. Moreover, inserting drain showed increased incidence of post operative wound infection & hospital stay, though these were statistically insignificant. More patients in the non drain group showed post-operative right shoulder tip pain in comparison to the drain group but that was also statistically insignificant. Conclusion: The decision of inserting drain should be taken judiciously on the basis of individual case scenario. The generalized approach of putting abdominal drain after every standard laparoscopic cholecystectomy is not at all beneficial.

BACKGROUND Dacryocystorhinostomy (DCR) can be performed via two approaches either external approach or endonasally. Earlier, external approach was preferred but with the recent introduction of endoscopy, the focus has shifted to endoscopic DCR as it is a less invasive procedure. This study was conducted to compare both the approaches. METHODS 50 patients were selected from patients attending eye and ENT OPD of a medical college in Kolkata with complaints of watering and / or discharge or with other features of chronic dacryocystitis e.g., mucocele, pyocele etc. They were then allocated in to two groups, group A (patients who will undergo endo DCR) and group B (patients who will undergo external DCR). Results of both were compared. RESULTS The mean age of study population was 34.34 ± 6.65 yrs. Among the study population, 36 patients (72 %) were female and 14 were male (28 %). Mean age of Group A (i.e. patients subjected to endo DCR) was 34.60 ± 5.72, while that of Group B (patients undergone external DCR) was 34.08 ± 7.58 yrs. Patients had a right sided predilection for DCR operation (66 %). Most common presenting symptom was epiphora (66 %) followed by epiphora with discharge. Mean time taken for the operation was significantly (p < 0.0001) more in group B (117 ± 14.43 mins) compared to that in group A (46.60 ± 8.63 mins). Massive intraoperative bleeding was more common in group B (32 %) compared to that in group A (p = 0.0023). Group B had a significantly higher rate of post-operative complications (56 %) compared to that in group A (p = 0.00085). Group B also had a higher success rate compared to group A; but this difference was not significant. (p = 0.22144). CONCLUSIONS Both the approaches have their own merits and demerits; but both are accepted alternatives, so either approach could be performed depending on the situation. KEYWORDS Endoscopic DCR, External DCR, Epiphora