BACKGROUND/AIMS: Laparoscopic cholecystectomy, which brought on innovative progress in the field of gallbladder surgery, has been widely employed. We analyzed the outcome of laparoscopic chole cystectomy to assess its clinical importance. METHODS: We retrospectively analyzed 500 cases of laparoscopic cholecystectomy performed at our department from November, 1991 through June, 1997 RESULTS: The mean age was 49.5 years and the male-to-female ratio was 1:1.4. Nineteen percent o the patients had a history of previous abdominal surgery. The mean operation time was 69.8 minutes Conversion to open cholecystectomy was necessary in seven patients (1.9%) of mild wall-thickening group (378 cases) and twelve patients (11.7%) of severe wall-thickening group (103 cases). The difference was statistically significant (p<0.05). The most common pathologic diagnosis was chronic cholecystitis. CONCLUSIONS: Laparoscopic cholecystectomy has become the 'gold standard 'for the treatment of symptomatic gallstones and chronic cholecystitis. However, understanding the method of open cholecystectomy is essential because conversion to open cholecystectomy is necessary for some cases with severe gallbladder wall thickening.