Gallbladder stones are the most common surgical disease of the digestive system. The incidence of gallbladder stones in China is 5% to 10%, and the peak season for gallbladder stone attacks is autumn and winter due to colder temperatures. The formation of gallbladder stones is an intricate process, and the exact cause is unknown. Consensus causes have emerged, including abnormal cholesterol metabolism, bile nucleation, and gallbladder emptying dysfunction. Most patients with gallbladder stones have episodes of acute cholecystitis or biliary colic with increasing age and prolonged medical history; only a few patients present with a stationary stone phase and do not have episodes throughout their lives, which are found at autopsy. Stones with a diameter of about 1 cm are very likely to cause ton, secondary biliary colic; induce biliary tract infection, symptoms of acute cholangitis, and further development can cause serious sepsis, which is life-threatening; if stones enter the common bile duct, they can cause secondary common bile duct stones, or even acute biliary pancreatitis, which is also life-threatening; the most dangerous is that gallbladder stones are likely to cause recurrent gallbladder infection, irritation and secondary bile duct The most dangerous thing is that gallbladder stones are prone to recurrent gallbladder infection, irritation and secondary bile duct lesions and gallbladder cancer. Therefore, a small stone should not be taken lightly to cause a “big disaster”. More than 95% of patients with gallbladder stones clinically require surgical treatment. Patients with acute calculous cholecystitis should be operated promptly; while patients with chronic gallbladder stones or gallbladder polyps, such as recurrent attacks, digestive dysfunction and discomfort should also be seen promptly; for those patients with multiple or large stones (>2.5 cm in diameter), hairy gallbladder wall, thickened, fibrotic or atrophic gallbladder should be surgically removed promptly after imaging. Patients with acute biliary pancreatitis or acute obstructive purulent cholangitis should undergo emergency cholecystectomy; after entering the aging society, elderly patients with bile duct stones often have other organ dysfunctions and insufficiencies, so they should go to the specialist in time. Because of the weak response of the body, slow and atypical onset, inconsistent signs and pathological changes, and atypical clinical manifestations, elderly patients with cholelithiasis are easily misdiagnosed and delay the best time for surgical treatment. Because of this, the risk of elective surgery in such patients is much lower than that of emergency surgery. Cholecystectomy Over the past 100 years since the world’s first open cholecystectomy was successfully performed in 1882, surgeons have conducted unremitting research and exploration on the surgical treatment of gallbladder stones. Nowadays, the main surgical treatment methods are laparoscopic cholecystectomy, small incision cholecystectomy, biliary stone extraction, NOTES surgery and classical traditional open cholecystectomy, whose final results are minimally invasive and good functional recovery. The main manifestations are small or no incisions on the body surface, reduced or disappeared incisional complications, and aesthetic skin; rapid postoperative recovery, with the ability to eat and move around on the same day and shortened hospital stay. At present, the most widely used laparoscopic cholecystectomy is minimally invasive, with few complications, wide indications, clear efficacy, and no hidden danger of gallbladder stone recurrence; moreover, it can minimize the psychological and physiological trauma of patients. It has now become the gold standard for the surgical treatment of gallbladder stones and gallbladder polyps. The treatment concept of biliary stone extraction is to maintain the integrity of human organs, which is in line with the concept of minimally invasive, but its treatment indications are narrower than laparoscopic cholecystectomy, and there are greater restrictions on the nature, number, and size of stones, if there is a comprehensive examination, evaluation, and strict case selection, a small proportion of patients still have the conditions and opportunities for biliary stone extraction. However, issues such as stone recurrence remain to be confirmed by data from prospective cohort studies.