In abdominal surgery, especially hepatobiliary and other surgeries, it often causes high catabolism, severe inflammatory reaction and suppression of immune function in the body, which increases the incidence of postoperative complications and mortality. Compared with traditional open surgery, minimally invasive surgery can significantly reduce the inflammatory response and immune dysfunction caused by surgical stress, alleviate patients’ pain, facilitate the postoperative recovery of multi-organ functions such as lung, heart, kidney and intestine, and shorten the postoperative hospital stay. Minimally invasive surgery is one of the development directions of surgery. With the accumulation of laparoscopic surgery experience and improvement of technology, laparoscopic cholecystectomy (LC) has developed from four-hole to three-hole, two-hole and even single-hole cholecystectomy. 35 cases of two-hole LC were successfully performed by two-hole (umbilical and subxiphoid) method from October 2009 to April 2010, with remarkable clinical results. The results were remarkable. Selection of surgical cases: benign bulging gallbladder lesions; asymptomatic gallbladder stones; simple gallbladder stones with chronic cholecystitis (controlled without obvious inflammatory response for at least 1 month after acute attack); stone impaction but clear anatomy of the gallbladder triangle, otherwise change to conventional LC surgical approach or open surgery. Exclusion criteria for surgical cases: acute cholecystitis; history of acute attacks of chronic cholecystitis within 1 month before surgery; atrophic cholecystitis and history of previous abdominal surgery as well as overly obese patients; those with contraindications to conventional LC surgery; those with severe local adhesions found after entering the abdomen. In 35 of 36 cases, the two-hole LC was successfully completed, and in one case, due to heavy adhesions, a drainage needed to be placed after freeing the gallbladder, so an additional hole was decided to be made in the right abdominal wall to drain the drainage tube, and the operation time ranged from 25 to 70 min, with an average of 37.3 min. Two-port cholecystectomy has been one of the routine surgical options for cholecystectomy in Europe and the United States, and Poon’s study showed no significant difference in safety between two-port cholecystectomy and conventional cholecystectomy. With the advancement of the two-port cholecystectomy technique and the proficiency of the operation, the safety has been further ensured. Breakthroughs and developments in miniature laparoscopic instrumentation have shown a significant reduction in postoperative patient pain in four randomized controlled clinical trials of two-port LC compared to standardized LC. In the present data, there is no specific data directly suggesting the postoperative pain sensation of patients, but the postoperative hospital stay of patients can indirectly reflect the degree of pain sensation of patients. The average postoperative hospital stay of 3.4 days in this study was comparable to the average postoperative hospital stay of 3.2 days in the study of a large sample of data by Qi Jun’an et al. The general postoperative recovery of the patients also indicates that the two-port approach cholecystectomy can significantly reduce the postoperative pain of the patients and help the recovery of the postoperative organism, which is in line with the basic concept of rapid recovery surgery. However, in two-port LC surgery, it has been reported that approximately 38% of patients in a randomized controlled clinical trial required conversion to conventional LC surgery. In contrast, there was only one case in this study in which the surgical separation was difficult and the dissection surface was large, and the procedure was converted to a three-port approach because of the need to place drainage, with a high surgical success rate of 97.2%. The reasons for such a high surgical success are mainly due to the following factors: (1) the surgical cases were optimally selected according to strict uniform inclusion and exclusion criteria: benign augmentation lesions of the gallbladder; asymptomatic gallbladder stones; simple gallbladder stones with chronic cholecystitis (controlled without significant inflammatory response for at least 1 month after acute attack); stone impaction but clear anatomy of the gallbladder triangle, otherwise converted to conventional LC surgical approach ; (2) the number of samples was small. Since the two-hole method of cholecystectomy was only carried out in this unit, the selection criteria for cases were relatively strict, and their indications will be relatively relaxed as the technology matures. The choice of surgical instrumentation in the micro-LC surgical approach has a great impact on the successful performance of the procedure. In the study by Bisgaard et al [5] with a 2-mm Trocar, nearly 40% of the cases required intermediate conventional LC or open surgery, whereas in the surgery by Lai et al, a 3-.5-mm Trocar was selected in 60% of the cases in which the two-port approach cholecystectomy was completed. In Lee et al. the two-port LC was successfully applied in 90% of cases with the same 3-mm Trocar. In view of the above multiple studies and the fact that we are in the exploratory stage of two-port cholecystectomy surgery, coupled with the fact that the instruments we used were common instruments for conventional LC, the surgical cases enrolled in the group were optimally selected to ensure a high success rate of the surgery. Operative time is an important aspect affecting postoperative recovery, and the operative time in this study ranged from 25 to 70 min with an average of 37.3 min, which is still longer than conventional LC at this stage compared with conventional LC surgery. On the one hand, both the grasping forceps and laparoscope for the two-hole method of LC assistance were inserted through the subumbilical poke hole, which easily interfered with each other and mutually affected the range and direction of activities, limiting the grasping forceps to pull the gallbladder and easily making the Calot triangle inadequately unfolded, increasing the operational difficulty and affecting the smooth operation. On the other hand, it is closely related to our lack of special instruments and the proficiency of operation. In the initial surgery, the operation time was around 1 hour or more, but nowadays, most of them are stable at 30-40 min. If special instruments are provided, it is believed that the operation time will be further shortened and the trauma will be further reduced. Because of the two-hole method of cholecystectomy, the patient has no obvious surgical scar after surgery, and this cosmetic effect is very popular for young patients, especially female patients, and it has been confirmed through preliminary studies that there is no significant difference between the two-hole method of LC and traditional LC surgery in terms of safety. As long as the indications and surgical techniques are strictly mastered, the two-port LC can also achieve the same therapeutic effect as traditional LC. In conclusion, the two-port technique for LC is based on traditional LC and can be performed safely after mastering the LC technique. Two-port LC is a safe and effective minimally invasive surgical option that provides patients with an additional choice because of fewer incisions, less trauma, faster recovery and better cosmetic results.