1. Are gallbladder stones related to gallbladder cancer? Gallbladder stones are an important factor in the development of gallbladder cancer. As early as the end of 19th century, it was recognized that gallbladder cancer patients had gallbladder stones at the same time, and Graham et al. suggested that gallbladder stones were related to gallbladder cancer based on the phenomenon that 69%-100% of gallbladder cancer patients had gallbladder stones and 4.5%-14% of gallstone patients had gallbladder cancer, and suggested gallbladder resection for gallbladder stone patients to prevent gallbladder cancer. In 2000, among 3922 gallbladder cancer cases in the national gallbladder epidemiological survey, 49.7% were combined with gallbladder stones, and the risk of gallbladder cancer in patients with gallbladder stones was 13.7%. 2.Does the physical examination reveal gallbladder stones, but no symptoms such as abdominal pain, need to be removed surgically? It is thought that the natural course of asymptomatic gallbladder stones is good and the percentage of developing symptomatic gallbladder stones is less than 20%, so prophylactic cholecystectomy is not recommended. More recent reports in the literature confirm that 10-38.5% of patients with asymptomatic gallbladder stones require surgical intervention, indicating that asymptomatic gallbladder stones do not have a good course as previously thought. Therefore, once patients with asymptomatic gallbladder stones develop symptoms; or loss of gallbladder function; gallbladder-filled stones or occupy more than 50% of the gallbladder; gallbladder stones >2 cm in diameter; combined with gallbladder atrophy, etc. It is recommended to perform cholecystectomy as soon as possible, do not delay the treatment. 3.Will gallbladder polyp become gallbladder cancer? Polypoid lesions of gallbladder (PLG) include gallbladder polyps, gallbladder adenoma and adenomyosis of gallbladder. Non-neoplastic polyps (cholesterol, inflammation) are usually small and have no risk of becoming cancerous. Gallbladder adenomas have a significant premalignant potential and increase with the size of the tumor, making them an important precancerous lesion. Gallbladder adenomyosis is a chronic proliferative disease characterized by hyperplasia of the gallbladder glands and smooth muscle. In the past, it was thought that gallbladder adenomyosis had no malignant potential, but recent clinical observations and pathological studies have shown that gallbladder adenomyosis is a precancerous lesion. Especially segmental adenomyosis. 4.What factors are precancerous lesions of gallbladder cancer? Precancerous lesions of gallbladder include: atypical hyperplasia of gallbladder mucosa and adenoma of gallbladder are recognized as precancerous lesions of gallbladder. Some benign gallbladder diseases such as cholecystitis, gallbladder stones, gallbladder polyp-like changes and congenital abnormalities of pancreaticobiliary ducts may become precancerous lesions of gallbladder through certain pathophysiological processes, and then develop into gallbladder cancer. 5.Gallbladder stones may lead to gallbladder cancer, so does it need to remove the gallbladder immediately for small asymptomatic stones found in physical examination? Most scholars believe that surgery can be considered for the following conditions: (1) female patients over 50 years old with gallbladder stones; (2) recurrent gallbladder stones or chronic cholecystitis with a duration of >5 years; (3) limited or uneven thickening of the gallbladder wall as indicated by ultrasound; (4) porcelain-like gallbladder or calcification of the gallbladder wall; (5) gallbladder (6) gallbladder atrophy or significant thickening of the gallbladder wall; (7) combined with gallbladder polyp-like lesions; (8) stones >2 cm in diameter or multiple stones or filled stones; (9) combined with abnormal pancreaticobiliary duct connection; (10) previous choledochostomy or internal gallbladder drainage. 6.What if gallbladder cancer is found during laparoscopic cholecystectomy or postoperative pathology? We call it “accidental gallbladder cancer” when gallbladder is diagnosed as benign lesion such as gallbladder stone before surgery and then diagnosed as gallbladder cancer during or after pathological examination. For patients with accidental gallbladder cancer, if the pathological examination reveals carcinoma in situ (Tis) and stage T1a, as long as the surgical margins are negative and the gallbladder is not damaged during the operation, there is no need to operate again. However, patients with T2 or T3 stage need to undergo reoperation, including partial resection of liver, segmental resection of liver or even hemihepatectomy combined with lymphatic dissection. 7.Is chemotherapy effective after gallbladder cancer surgery? Gallbladder cancer lacks effective and sensitive chemotherapy drugs and reasonable chemotherapy regimen, but gallbladder cancer has some sensitivity to radiotherapy. For patients with advanced gallbladder cancer or after radical resection, local radiotherapy can be prescribed to prevent and reduce local recurrence.