In recent times, when sitting in the clinic, I often encountered some patients asking about biliary surgery, and even some patients with very obvious gallbladder stones and cholecystitis insisted on having biliary surgery. It seems that people are deeply influenced by the misleading propaganda on the Internet, and it is not easy to change their views for a while; in addition, the clinic time is rather hurried, so it is too late to give a detailed explanation, and some patients still have a lot of doubts. Therefore, I would like to take this platform to write a few small articles that are easy to read and understand, and try to explain the reasons and justifications for not doing biliary surgery. If, after reading, gallbladder patients can have a clear idea of whether their condition requires surgery, when to operate, and what kind of surgery to do, I will have achieved my goal, which is also the duty and responsibility of a hepatobiliary surgeon. 1.Why does the gallbladder grow stones? The main cause of gallbladder stones is the formation of cholesterol. The principle of gallbladder stones is not yet fully understood, but the two main factors that cause the gallbladder to grow stones easily are already known: one is the excessive cholesterol in the bile; the other is the weakened function of the gallbladder. Here I will talk to you about these two main unfavorable factors. First of all, why is the cholesterol in the bile too high? The simplest phrase: the standard of living has improved, too much cholesterol is eaten into the body and the bile is saturated with cholesterol! It should be noted that when eating the same food for a long time, some people have increased cholesterol, but others do not, and this is what we often call individual differences. High cholesterol in the bile and high cholesterol in the blood are closely related, but not exactly the same thing. That is, high blood cholesterol does not mean high cholesterol in the bile, but it is certainly more likely to occur in people with high cholesterol in the bile than in normal people. Unfortunately, there is no good clinical method to detect the cholesterol level in bile. Secondly, the weakening of gallbladder function: the gallbladder’s function of storing bile: bile is synthesized by the liver. Some patients are very worried that there will be no bile after removing the gallbladder and worry that it will have a great impact on their digestion, which is a misunderstanding. The main function of the gallbladder is to store and excrete bile. The liver secretes 800-1000ml of bile daily, most of which is concentrated by the gallbladder and stored in the gallbladder. When needed for digestion, it is then discharged by the gallbladder, so simply understood, the gallbladder can be regarded as a “transit station” for bile. When the function of the gallbladder is weakened for various reasons, the main reason is chronic inflammation of the gallbladder! Bile containing too much cholesterol is not discharged from the gallbladder in a timely manner, and when it is concentrated in the gallbladder for a long time, saturated cholesterol tends to precipitate and gradually form stones. If a person, when the cholesterol in his bile is in a saturated state and at the same time the function of the gallbladder is weakened, with these two conditions, it is easy to grow stones in the gallbladder. Here, I would like to ask you a thoughtful question: If gallbladder stones have already occurred and surgery is needed, but we only remove the stones and keep the gallbladder that already has chronic inflammation, what will happen in the future?