ABSTRACT
Patients with gallstones disease, as with any other patients, have to undergo a complete clinical evaluation for the disease-related issues and general issues pertaining to fitness for surgery. The disease evaluation includes assessment of the gallbladder for stone/s as well as associated pathology. The risk of conversion to open cholecystectomy should also be assessed prior to cholecystectomy. A gallbladder wall thickness of more than 4–5 mm, a contracted gallbladder, age > 60 years, male gender, acute cholecystitis, obesity and previous laparotomy are considered predictors of a difficult cholecystectomy. The exclusion of common bile duct stone by clinical, biochemical and imaging modalities is an essential part of preoperative evaluation.
