Factors that have been found in the literature to be predictive of a difficult LC include age, gender, acute cholecystitis at presentation, previous surgery on the upper abdomen, obesity, high WBC count, low albumin, gallstone size, GB wall thickness, number of stones, common bile duct diameter, and impacted stone at GB neck. Of these, patients older than 65 years old, a history of upper abdominal surgery, a thick GB wall, a constricted GB, an impacted stone at GB neck, and male sex showed maximum correlation [2-15]. The gene discussed is ALB; the disease is obesity due to melanocortin 4 receptor deficiency.