Background: Gallstone disease is one of the most common diseases of the gastrointestinal system; laparoscopic cholecystectomy is the gold standard operation for the definitive treatment of gallstones. Ultrasonography is the imaging technique of choice in detection of gallstones and is effective for follow-up of cholecystitis course. The operation can range from easy not complicated with obvious Calot’s triangle to difficult surgery with obscure anatomy and may require conversion to open.

Aim of study: Utilization of pre-operative Ultrasonographic results in patients with chronic calculus cholecystitis to anticipate difficulties during laparoscopic cholecystectomy and to correlate preoperative Ultrasonographic findings with intra-operative findings during cholecystectomy.

Patients and method: It is an analytic cross-sectional study with 102 patients were operated on, the age group of the patients ranged from 15 to 70 years. The most prevalent sample was female (74%), 4 Ultrasonographic parameters were taken pre operatively including Gallbladder size, Gallbladder wall thickness, Gallstone mobility, Common bile duct diameter, and intraoperative parameters (total operation time, Calot’s triangle dissection time, stripping of gallbladder time, any difficulty in extraction or spillage, and if it required conversion to open surgery.

Results: In the current study the result showed 66.7% of patients had ultrasound findings that predicts easy surgery and 33.3% had an ultrasound report that predicts difficult surgery, 31 patients of the before mentioned 33.3% had difficult surgeries while only 3 patients didn't, 2 statistically significant association (p=0.001). the positive predictive value was 91.5% while sensitivity was only 65% and specificity 97% for gallbladder wall thickness, while for contracted gallbladder the positive predictive value was 95% and (p=0.002), The positive predictive values for stone impaction and Common bile duct dilatation were (96%, 100%) respectively.