The occurrence of gallbladder cancer may be due to long-term ischemia of gallbladder mucosa caused by compression and stimulation of gallbladder stones, mucosal epithelial hyperplasia, abnormal proliferation and mutation caused by repeated injury and chronic inflammation, as well as bile emptying disorder and carcinogenic substances in bile such as cholestatic acid, cholanthrene and methylanthracene may be the causes of cancer. Therefore, in order to achieve pre-emptive prevention, it is advocated that active measures should be taken to perform prophylactic cholecystectomy in high-risk groups. The indications for surgery are as follows: (1) patients aged 55 years or older with cholecystitis or cholelithiasis of more than 5 years’ duration; (2) patients with stones >2 cm in diameter or gallbladder neck embedded stones of more than 10 years’ duration; (3) patients with significant changes in the nature and rhythm of abdominal pain; (4) patients with gallbladder polyp-like changes of >1 cm in diameter with wide base or thick tip; (5) patients with ultrasound indicating significant thickening of the gallbladder wall, limited thickening, irregular thickening, or gallbladder thickening. (5) Ultrasound indicates significant thickening, limited thickening, irregular thickening, or gallbladder atrophy; (6) CT scan shows limited irregular or diffuse thickening of the gallbladder wall, convexity and unevenness of the lumen wall, and significant enhancement of the gallbladder wall on enhanced scan; (7) porcelain gallbladder; (8) previous cholecystostomy; (9) congenital confluence anomaly of the pancreaticobiliary duct. For high-risk patients who cannot be operated, regular follow-up and dynamic monitoring should be performed to facilitate the early detection and treatment of gallbladder cancer.