Elderly women, large stones, adenomatous polyps The etiology of primary gallbladder cancer is still unclear. However, it has become a consensus that cholecystitis, cholelithiasis, bacterial infection, disturbance of bile acid metabolism and mucosal hyperplasia of gallbladder are related to the occurrence of gallbladder cancer. In addition, high-fat diet, smoking and alcoholism are also risk factors for the occurrence of gallbladder cancer. The ratio of male to female incidence of gallbladder cancer is 1:2.7, and the average age of incidence is 65.2 years. In early stage, there are often no specific symptoms, and when found, it is mostly in advanced stage, and only those who can be surgically removed can have a longer survival. According to domestic statistics, 31.6% of gallbladder cancer patients have gallbladder stones at the same time; the occurrence of gallbladder cancer is closely related to the size of stones, and the incidence of gallbladder cancer is 1.0% for stones <10mm in diameter; 2.4% for stones 20-22mm in diameter; 10% for stones >30mm in diameter. Gallbladder polyps are divided into cholesterol polyps and adenomatous polyps. Adenomatous polyps have a much higher chance of malignant transformation if they are single, broad-based polyps with a diameter >1cm. Foreign studies have shown that there may be a pathogenetic sequence between benign polyps of the gallbladder, gallbladder adenoma and gallbladder cancer, and it usually takes 3 to 10 years for atypical hyperplasia to develop into cancer. Cholesterol polyps, on the other hand, are not cancerous, so when you encounter this type of patients, you can let him relax. In conclusion, clinically, when encountering middle-aged and elderly women over 60 years old who have filled gallstones or have gallbladder polyps over 1 cm or porcelain gallbladder, extra emphasis needs to be placed on regular close review or even preventive gallbladder removal. If patients undergo surgery for stones or polyps, they need to be sent for intraoperative rapid pathological examination to avoid a second surgery for postoperative diagnosis of cancer.