Background and Aims: Reduced fibrinolytic activity of the peritoneum seems to be the main cause of postoperative adhesions. This prospective randomized trial compared the peritoneal fibrinolytic system activity changes between laparoscopic and conventional cholecystectomy. Methods: Parietal peritoneal biopsy specimens were taken in standardized elective laparoscopic (n=20) and conventional (n=20) cholecystectomy at the beginning and at the end of surgery. Concentrations of tissue-plasminogen activator (tPA), plasminogen activator (PAI) type 1 were determined by ELISA kits to evaluate the changes in the fibrinolytic system along the operation time in either procedure. Results: there was no significant difference in the activity of tPA, PAI-1 between the groups suggesting any preference for either group for adhesion formation. Conclusion: there is no difference between the effects of laparoscopic procedure on the changes in the fibrinolytic system in peritoneal tissue compared to open surgery.