Gallbladder stones are a common disease in China, with a prevalence of 10%-15% in the normal population and a higher incidence in developed countries than in developing countries. With the continuous improvement of living standard, the incidence of gallbladder stones in China is increasing as well as obesity, hypertension, hyperlipidemia, coronary heart disease, diabetes and other diseases. Patients complaining of gallstones are often encountered in outpatient clinics, asking doctors what to do. Gallstones is not a standardized diagnosis, but a medical term for gallstone disease, including gallbladder stones and bile duct stones, and most patients are talking about gallbladder stones. Here is a brief introduction to the etiology, diagnosis and treatment of gallbladder stones. I. Etiology of gallbladder stones Gallbladder stones are mainly seen in adults, more women than men, and the incidence increases with age after the age of 40. The stones are cholesterol stones or a mixture of cholesterol-based stones and black bile pigment stones. Patients often ask why they have gallbladder stones, which is the medical cause of the disease. Gallbladder stones are associated with a variety of factors, in general, with the composition of the bile and its physicochemical properties. Any factor that affects the ratio of cholesterol to bile acid concentration and causes bile stagnation can lead to stone formation. Individual regional and ethnic residents, female hormones, obesity, pregnancy, high-fat diet, long-term parenteral nutrition, diabetes mellitus, hyperlipidemia, after gastrectomy or gastrointestinal anastomosis, terminal ileal disease and ileal resection, cirrhosis of the liver, and hemolytic anemia can all cause gallbladder stones. Gallbladder cancer is closely related to the existence of gallbladder stones, and the longer the course of gallbladder stones, the higher the incidence of gallbladder carcinoma. The occurrence of gallbladder cancer may be the result of the combination of gallbladder stones, long-term physical stimulation, chronic inflammation of gallbladder and carcinogenic substances in the products of infection. II. Diagnosis of gallbladder stones Some patients are asymptomatic and have no uncomfortable feeling, and are only found during physical examination, which is called stationary gallbladder stones. The typical symptom of gallbladder stones in some patients is biliary colic, which manifests as acute or chronic cholecystitis. Patients often experience colic after a full meal, eating fatty food or when their position changes during sleep. The pain is located in the right upper abdomen or epigastrium, and some patients are unable to name the exact location of the pain because it is severe. It is often mistaken for stomach pain or angina, and the pain can sometimes be relieved by taking stomach medicine or heart pills. Most patients only feel vague pain in the upper abdomen or right upper abdomen when they overeat, eat high-fat food, work under stress or have poor rest, or have fullness, belching, or erratic pain, which can be easily misdiagnosed as “stomach disease”. Based on the typical clinical history of colic, imaging can confirm the diagnosis. Ultrasonography is preferred, while CT and MRI are mainly aimed at screening for combined common bile duct stones. In patients with gallbladder stones, before surgery, clarification of the presence or absence of common bile duct stones should be sought. When the preoperative examination cannot be determined, the specific surgical procedure can be decided according to the surgical situation. III. Treatment of gallbladder stones Although a variety of non-surgical methods (such as lithotripsy, extracorporeal lithotripsy and herbal lithotripsy) are explored for the treatment of gallbladder stones, the results are not satisfactory. At present, the most effective clinical treatment method is surgical treatment, i.e. cholecystectomy. Over the past 30 years, laparoscopic cholecystectomy has been widely used, and more than 95% of cholecystectomies can be done laparoscopically. All symptomatic gallbladder stones should be cholecystectomized. Asymptomatic gallbladder stones generally do not require active surgical treatment and can be observed and followed up, but surgery should be considered in the following cases: stones ≥ 2-3 cm in diameter; combined with surgery requiring open abdomen; with gallbladder polyps; thickened gallbladder wall; calcified gallbladder wall or porcelain gallbladder; gallbladder stones in children; combined with diabetes mellitus; with cardiopulmonary dysfunction; remote or underdeveloped transportation areas, field workers; gallbladder stones found More than 10 years and other conditions. Some critically ill patients with acute cholecystitis attacks cannot tolerate surgery with general anesthesia, and should undergo percutaneous transhepatic cholecystocentesis and drainage (PTGD), and postpone the surgery after their general condition improves. In recent years, a small number of doctors in China have carried out biliary lithotripsy, but this procedure is not carried out in other countries, and is a controversial procedure, and most biliary surgeons still advocate cholecystectomy. Many patients are worried that without a gallbladder, they cannot eat meat. This is a wrong understanding. The function of the gallbladder is to store, concentrate and discharge bile, which is secreted by the liver. After removal of the gallbladder, the common bile duct compensates for the expansion and replaces the concentrating function of the gallbladder to some extent. In conclusion, when gallbladder stones are found, they should be seen at a specialized hepatobiliary clinic and diagnosed and treated by a specialist.