In the period of January 2011 to October 2011, laparoscopic cholecystectomy was attempted in 150 patients suffering from symptomatic cholelithiasis. A retrospective analysis of parameters, including patient demographics, laboratory values, radiologic data, and intraoperative findings, was performed. Univariate and multivariate analysis was done to determine those variables predicting conversion. Elderly, male gender, leucocytosis, a history of previous upper abdominal surgery, preoperative ERCP, USC evidence of thickened GB wall >4mm, high-grade adhesion, and thickened wall of the gallbladder intraoperatively were predictive factors of conversion to open surgery. LC was successfully completed in 138 patients (92%), whereas a conversion to open surgery was required in 12 patients (8.0%). Patient selection is very important for efficient, safe training in LC. Pathways could be suggested, enabling the surgeon to precisely decide during LC when to convert to open surgery.