Gallstones for more than 20 years without pain should be treated according to the individual specifics can be taken regular observation or surgical treatment. Gallstones are a common benign disease of the gallbladder, and when they occur, different treatment measures should be chosen according to the specific conditions of the individual. 1. If the gallbladder stones have been present for 20 years without any symptoms, and the stones are small in size and do not need to undergo surgery for the time being, regular observation can be taken. 2. If gallbladder stones are painless for more than 20 years, but there is obvious thickening of the gallbladder wall in the gallbladder examination, combined with gallbladder polyps, a large number of stones, a large diameter of the stones, gallbladder atrophy, porcelain, or accompanied by obvious hypertension, diabetes and other underlying diseases, should be operated as soon as possible. Long-term gallstones without obvious symptoms, should be based on specific conditions, under the guidance of the doctor for standardized treatment.