Hello, It is indeed a a dilemma for many surgeons whether to go ahead with the surgery or not.Laparoscopic cholecystectomy remains the standard treatment for cholelithiasis. Ever increasing number of patients with many co- mrbidities are being treated by this technique. However, significant concern prevails among the surgical community regarding its safety in patients with cardiac co-morbidity.  A very large study of such patients was undertaken and it showed that laparoscopic cholecystectomy may be safely performed in patients with significant cardiac dysfunction. Such patients need proper evaluation by cardiologists and anesthesiologists  If considered safe to undergo general anaesthesia, such patients should not be denied the benefits of laparoscopic cholecystectomy. Optimization of cardiac status, administration of balanced anaesthesia and low-pressure pneumoperitoneum are essential steps to ensure patient safety. The chances of life threatening complications are rare, and in the eventuality, can be easily managed in a hospital with adequate cardiological support. Discuss with a cardiologist and an anaesthetist and abide by their evaluation. Thanks