A controlled analysis of 360 cases of gallbladder lesions diagnosed by ultrasound and cholecystectomy performed laparoscopically in our hospital was performed. METHODS: Ultrasound instruments were used to observe and record various types of gallbladder disorders. RESULTS: The compliance rate between ultrasound diagnosis and surgery was 99.4%. CONCLUSION: Ultrasonography can help the clinic to correctly select surgical methods and surgical indications. Ultrasound diagnosis of gallbladder diseases is accurate, provides a basis for choosing surgical treatment, and can monitor the occurrence of complications in the postoperative period and take timely therapeutic measures, which has greater practical value. This paper summarizes 360 cases of gallbladder lesions and laparoscopic cholecystectomy from January 04 to January 08, all of which were examined by ultrasound before surgery, and is summarized as follows to discuss the diagnostic value of ultrasound in the use of laparoscopic cholecystectomy. Data and methods: General data: this group reports 360 cases were confirmed as gallbladder lesions by surgery, and all of them were confirmed by pathological examination, 102 male cases, 258 female cases, male: female = 1:2.53, age 20-82 years old, average age male: 54.5 years old; female: 48.5 years old. Instruments: PHLIPS Envisor C color Doppler ultrasound; ALOKA SSD-1100 black and white ultrasound. Probe frequency 3.5MHz. Examination method: patients were fasted in the morning, fasted for more than 8 hours, and serial scans were performed in transverse, longitudinal, subcostal and intercostal oblique sections of the upper abdomen to observe and record the size of the gallbladder, the thickness and changes of the wall of the gallbladder, the number of intracapsular light masses or light spots, their size, mobility, and the presence or absence of acoustic shadows, the internal diameter of the common bile duct and the common hepatic duct, and whether there were any stones and other lesions, anatomical structures, etc., respectively. All cases were patients with gallbladder disorders who had patent common bile duct and common hepatic duct without obstructive lesions on ultrasonography. RESULTS: In this group, 358 cases of ultrasonographic diagnosis were compatible with surgery, with a compliance rate of 99.4%. 358 cases of laparoscopic cholecystectomy were successful, and 2 cases of intermediate open surgery. DISCUSSION: Ultrasonography is an indispensable means of examination before laparoscopic cholecystectomy, and the compliance rate between ultrasonographic diagnosis and surgery in 358 cases in this group was 99.4%. After laparoscopy, ultrasound can be used to observe whether there are complications and changes, or to monitor the self-absorption of effusion, and ultrasound-guided puncture or timely laparotomy can be performed if necessary. Extrahepatic bile duct obstruction is a contraindication to laparoscopic surgery and is prone to accidents, therefore, preoperative ultrasound is very necessary to know whether there are stones in the extrahepatic bile ducts and whether there is obstruction of the common bile ducts, because intrahepatic and intracystic stones may be discharged into the common bile ducts with the bile, and in order to avoid the selection of the laparoscopic indications, it is preferable to examine the common hepatic ducts and the common bile ducts the same day as or the day before the operation to check the patency of the common hepatic ducts and common bile ducts more reliably. If secondary choledocholithiasis is detected, the procedure is changed to direct laparotomy. For single and multiple gallbladder stones with a wall of ≤3 mm, 100% of the patients in this group had a chronic gallbladder, therefore, ultrasound diagnosis of gallbladder stones should suggest the diagnosis of cholecystitis. Regarding the range of indications, with the improvement of laparoscopic surgical techniques and the accumulation of experience, many relative contraindications have been expanded into indications, such as gallbladder stones secondary to choledochal stones, acute cholecystitis, and those who have epigastric surgery to estimate that the adhesion is not serious, laparoscopic cholecystectomy can also be considered. In this group, nearly 20% of the cases have adenomyosis of the gallbladder, which is difficult to characterize by ultrasound, but the thickening of the gallbladder wall should be carefully observed, and the uneven thickening of the gallbladder wall should be taken into account, so as to exclude the possibility of occupying the gallbladder. In the case of bile sludge formation, most of the postoperative contents have been lost before delivery for examination, so it is impossible to accurately control. For the surveillance of complications such as postoperative subhepatic effusion, ultrasound can be compared before and after, measured and recorded, which is simple and easy to do and provides valuable data for the clinic. Ultrasound diagnosis of gallbladder and biliary tract diseases is accurate in its conclusions, providing a basis for clinical selection of surgical methods, and the preoperative estimation of surgical difficulties is sufficient, and the surveillance of postoperative changes and complications has a greater practical value, and at the same time, it expands the indications for surgery and improves the success rate of surgery, which is a more desirable diagnostic method at present.