Objective Evaluation of application value of gastric insufflation monitored by ultrasonography during anesthesia induction under laparoscopic cholecystectomy. Methods Sixty-four adult patients undergoing laparoscopic cholecystectomy were randomly allocated into 4 groups (P10, P15, P20, and P25, n=16), defined by the inspiratory pressure applied during controlled-pressure ventilation: 10, 15, 20, 25 cmH2O (1 cmH2O=0.098 kPa). After induction of anesthesia, facemask ventilation was started by relevant pressure. Blood pressure, heart rate, pulse oxygen saturation (SpO2), and tidal volume were recorded at 45 s, 90 s, 135 s, 180 s after facemask ventilation and intubation. During ventilation, gastric insufflation was detected by auscultation and by the cross-sectional antral area measured using ultrasonography. Results The research registered statistically increases incidences of gastric insufflation with inspiratory pressure, from 13% (2/16) (group P10) to 81% (13/16) (group P25) according to ultrasonography monitor (P<0.05), and from 0 (0/16) (group P10) to 38% (6/16) (group P25) according to auscultation. For peak airway pressure of 15 cmH2O (P<0.05), the probability of ensuring adequate oxygen supply and minimizing gastric insufflation was the highest, whereas probability of absence of gastric insufflation was 69% (11/16). Conclusions Real-time ultrasonography of the antrum allowed for detection of gastric insufflation with high sensitivity, inspiratory pressure of 15 cmH2O allowed for reduced occurrence of gastric insufflation with proper lung ventilation during anesthesia induction of laparoscopic cholecystectomy. Key words: Anesthesia, general; Gastric insufflation; Auscultation; Ultrasonography