Introduction: Laparoscopic cholecystectomy (LC) has become the gold standard for the management of symptomatic cholelithiasis due to its minimal invasiveness and faster recovery. However, it carries a risk of intraoperative and postoperative complications that can impact patient outcomes. Understanding these complications in a local institutional setting is essential for improving surgical safety and patient care. Objectives: To evaluate the incidence, nature, and outcomes of complications associated with laparoscopic cholecystectomy performed at our tertiary care center, and to identify factors associated with increased risk of complications. Methods: This retrospective observational study was conducted over a one-year period at Institute of Post-Graduate Medical Education and Research and Seth SukhlalKarnani Memorial Hospital, Kolkata and Nil Ratan Sircar Medical College and Hospital, Kolkata. and included 100 patients undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. Data were collected from medical records and analyzed for intraoperative and postoperative complications, causes of conversion to open surgery, and bleeding events. Patient demographics and clinical variables, including age, gender, presence of acute cholecystitis, gallbladder wall thickness >4 mm, presence of adhesions, and operative time exceeding 90 minutes, were also recorded to assess their association with complications. Results: Among 100 patients undergoing laparoscopic cholecystectomy, 18% had complications. Intraoperative bile duct injury occurred in 1%, bleeding in 2%, gallbladder perforation in 4%, and bile leak in 6%. Conversion to open surgery was required in 5%. Postoperative complications included bile leak (6%), surgical site infection (3%), fever (5%), intra-abdominal collection (2%), pulmonary complications (1%), and reoperation (1%). No mortality was reported, and no patient or operative factor showed a significant association with complications. Conclusion: Laparoscopic cholecystectomy remains a safe and effective procedure for the management of gallstone disease. Most complications are minor and manageable; however, careful patient selection, meticulous surgical technique, and prompt recognition of complications are essential to minimize morbidity. Institutional audit of complications can help refine surgical protocols and enhance patient safety.

Introduction: Tympanoplasty is a surgical procedure aimed at repairing tympanic membrane perforations and restoring hearing. The underlay and overlay techniques are commonly employed, but there is ongoing debate regarding which approach yields better functional and anatomical outcomes. Aims: To compare the outcomes of underlay versus overlay tympanoplasty in patients with central and subtotal tympanic membrane perforations, in terms of graft success, postoperative hearing gain, and complications. Materials and Methods: The present study was a prospective comparative study. This study was conducted over a period of 16 months (February 2020 to May 2021) at the Department of Otorhinolaryngology, KPC Medical College & Hospital, Kolkata, West Bengal, India, and Pin-700032. The study population consisted of 50 patients with central tympanic membrane perforations who attended the outpatient department and fulfilled the inclusion criteria. Result: The underlay group demonstrated higher postoperative hearing gain, with 21 of 23 patients (91.3%) showing improvement, compared to 13 of 22 patients (59.1%) in the overlay group. Graft success was strongly correlated with Eustachian tube patency, achieving 95.6% in patent ET cases versus 25% in non-patent ET cases. Duration of preoperative dry ear also influenced graft uptake, with the highest success seen in patients with 1–6 months of dry ear (92.8%). Complications were fewer in the underlay group, with graft failure in 2 patients (8%) and pinhole perforation in 2 (8%), compared to 3 (12%) graft failures and higher rates of lateralization, healing problems, and myringitis in the overlay group. Conclusion: Underlay tympanoplasty demonstrated superior functional and anatomical outcomes compared to overlay tympanoplasty, with higher hearing improvement, greater graft success, and fewer complications. The study supports the preferential use of the underlay technique for central and subtotal tympanic membrane perforations, particularly in patients with patent Eustachian tubes and adequately dry middle ears.

Introduction: Anterior tympanic membrane perforations pose unique surgical challenges due to poor graft support and limited visualization. Various surgical techniques, including the anterior pull-through method and conventional flap method, have been proposed to improve graft uptake and functional hearing outcomes. Aims: The study aims to compare the anterior pull-through and conventional flap methods of tympanic membrane grafting with respect to complete graft uptake and postoperative hearing improvement. Specifically, it evaluates differences in graft success and hearing outcomes between the two techniques. Materials & Methods: This prospective, comparative hospital-based study was conducted in the Department of Otorhinolaryngology, KPC Medical College & Hospital, Jadavpur, Kolkata, over a period of 18 months (1st January 2023 to 30th June 2024). A minimum of 94 patients undergoing tympanoplasty for anterior tympanic membrane perforations were enrolled and allocated into two groups by simple random sampling after appropriate counseling and informed consent. Result: A total of 94 patients were equally divided into two groups: anterior pull-through (n=47) and conventional flap (n=47). The mean age was comparable between the groups (38.38 ± 7.25 vs. 36.00 ± 8.02 years; p=0.1341), with similar age distribution across 21–30, 31–40, and 41–50 years (p=0.5284). Both groups also had identical sex distribution with 14 females (29.8%) and 33 males (70.2%) each (p=1.000). Graft uptake at 2 weeks was 93.6% in the anterior pull-through group and 89.4% in the conventional group (p=0.4597), while at 1 and 3 months, uptake rates remained similar (93.6% vs. 91.5%, p=0.6944). Preoperative mean PTA was 26.83 ± 2.99 dB in the anterior pull-through group and 27.49 ± 3.12 dB in the conventional flap group (p=0.2977). At 1 month, PTA improved to 17.51 ± 3.69 dB vs. 18.28 ± 4.15 dB (p=0.3476), and at 3 months, further improved to 9.90 ± 3.93 dB vs. 10.73 ± 5.58 dB (p=0.4056). Overall, both techniques demonstrated high graft uptake rates and significant hearing improvement, with no statistically significant differences between them. Conclusion: The study indicate that both the anterior pull-through and conventional flap techniques of tympanoplasty are highly effective in managing anterior tympanic membrane perforations, achieving excellent graft uptake and significant hearing improvement. Graft success rates remained consistently above 89% in both groups at all follow-up intervals, while postoperative air-bone gap closure was substantial and comparable. No statistically significant differences were observed between the two methods in terms of graft uptake or hearing outcomes, suggesting that either technique can be reliably employed, with the choice depending on surgeon preference and intraoperative considerations.