The early stages of gallbladder stones may be characterized by bile stagnation followed by the formation of bile sludge and stones. The basis of cholesterol stone formation is an imbalance in the ratio of cholesterol, bile acids and lecithin in the bile, resulting in the formation of crystals, precipitation, agglomeration and stones in the bile in a supersaturated state. Most of the cholesterol in bile originates from the biosynthesis of hepatocytes rather than from the secretion of cholesterol from the diet. The formation of cholesterol stones is mainly due to the supersaturation of cholesterol in bile synthesized by hepatocytes and the nucleation of cholesterol crystals promoted by proteins in bile, while other factors are attributable to the impaired motor function of the gallbladder, which act together to stagnate bile and promote the formation of gallstones. Differential diagnosis of biliary stasis: 1. Lithotripsy refers to the occurrence of stones in the gallbladder or in the neck of the gallbladder. The clinical manifestations depend on the location and size of the stones, whether they cause infection, obstruction, and the site and degree of obstruction. Calculous cholecystitis is the most common lesion in the biliary system. Depending on the location, there are gallbladder stones, primary or secondary common bile duct stones, extrahepatic bile duct or intrahepatic bile duct stones. Gallstones Gallstones are stones formed in the bile duct. The dissolved components of bile become non-soluble for some reason, forming crystals or precipitating out to form stones. According to their main components, they can be divided into three categories: cholesterol stones, bile pigment stones and rare stones with other components. The causes of gallstones include metabolic abnormalities, bile stagnation, and biliary tract infection. Cholesterol and bile pigments are insoluble in water, but they are dissolved in a micelle-like state by the action of bile acids and lecithin. If the above pathogenic factors change the composition of bile, such as a decrease in bile acids, the micelle state changes and the dissolved material is analyzed to form gallstones. Gallstones can also be found in other animals, and the Chinese medicine cow’s bile is a bovine gallstone. 3, gallstones After gallstones are formed in the gallbladder, they can stimulate the gallbladder mucosa, which can not only cause chronic inflammation of the gallbladder, but also cause secondary infection when the stones are embedded in the gallbladder neck or gallbladder duct, leading to acute inflammation of the gallbladder. Due to the chronic stimulation of gallbladder mucosa by stones, it may also lead to the occurrence of gallbladder cancer, and the incidence of such gallbladder cancer has been reported to be 1~2%.