Introduction: Symptomatic gall stone disease is a common ailment and affects about 10 to 15% of general population. Though the vast majority of cholecystectomies are performed laparoscopically, still the rate of conversion to open is 5% to 10%. Although cholecystitis, choledocholithiasis, male sex, and obesity are major predictors for conversion, there is a need to evaluate various other factors responsible for difcult laparoscopic cholecystectomy. Material and Methods: A total of 115 patients undergoing laparoscopic cholecystectomy for symptomatic gall stone disease in M S Ramaiah Hospital were studied from June 2013 to June 2015. The preoperative clinical and sonological data was compared with the intraoperative data and the outcome of surgery. Results: Disease was more common among women of 40–50 years. 10.4% patients had acute cholecystitis and 5.2% had liver cirrhosis. Symptoms and signs of acute cholecystitis, previous surgery, contracted GB, GB wall thickness > 4mm, Liver cirrhosis were predictors of conversion to open cholecystectomy. Conclusion: Certain parameters like symptoms and signs of acute cholecystitis, previous surgery, contracted GB, GB wall thickness > 4mm, liver cirrhosis, DM, and BMI>25 have signicance in predicting a diicult laparoscopic cholecystectomy and its conversion to open technique.

Keywords: Gall stone disease; Laparoscopic cholecystectomy; Open cholecystectomy.