Background: Laparoscopic surgery produces measurable effects on cardio-circulatory, respiratory and metabolic systems. Total intravenous anesthesia with propofol using target-controlled infusion technique guided by Bispectral Index monitoring ensures an optimum level of anesthesia. This study was designed to evaluate the hemodynamic changes with the use of BIS-guided TCI with propofol-fentanyl during either laparoscopic or open cholecystectomy. Methods: Twenty-four ASA class I-II patients, scheduled for cholecystectomy under general anesthesia using BIS-guided TIVA with propofol-fentanyl delivered by TCI pump, were divided surgically into laparoscopic surgery group (LS group, n = 12) and open surgery group (OS group, n = 12). Hemodynamic data as well as stress hormones were measured at various time intervals. Results: Within LS, there was rise of both cardiac output after abdominal insufflation (p