The incidence of gallbladder stones is higher in women than in men, about 2:1. 60% and 40% of the patients are asymptomatic or asymptomatic, respectively, and about 10% of the patients have biliary colic, bile duct stones, pancreatitis or gallbladder malignancy as complications. Should surgery be performed for gallbladder stones? When to operate? How to operate? Many people are very confused. In the era of minimally invasive surgery, our opinion is that gallbladder stones not only need to be treated, but also early treatment and early medical intervention, and not to wait passively to prevent the development of the symptomatic or complication stage. For patients with gallbladder stones, if the gallbladder is functional and the likelihood of a single stone or stone recurrence is low, bile-conserving stone extraction surgery may be an option. If the gallbladder is not functional, the inflammation is relatively heavy, the estimated improvement of clinical symptoms after elimination of stones is inexact or the stones are multiple in size, and the possibility of stone recurrence after surgery is high, laparoscopic cholecystectomy is recommended. Once the complication period is entered, such as acute cholecystitis (including gallbladder necrosis), combined with pancreatitis, laparoscopic cholecystectomy should be performed even earlier. Numerous medical experiences have confirmed that the principle of “early detection, early diagnosis and early treatment” is also suitable for gallbladder stones. With the maturity and recognized advantages of minimally invasive technology, minimally invasive gallbladder surgery with less trauma, faster recovery, less pain and high cost effectiveness has become the gold standard for the treatment of gallbladder stones. We try our best to adopt bile-preserving surgery for functional gallbladder, while for patients with symptomatic gallbladder stones, especially those with complications, we advocate early surgical removal of the gallbladder. Wang Weidong, Department of General Surgery, Shanghai Oriental Hospital