In Wenzhou area, the incidence of gallbladder stones has been very high and is a very common disease. As the gold standard of gallbladder stone and cholecystitis treatment, “laparoscopic cholecystectomy” (LC for short) has been developed very maturely over the past 30 years since its introduction, and is also recognized and gradually known by the majority of patients. However, in our usual clinical work, we have encountered various patients who have various misunderstandings about gallbladder stones and LC. I will now explain the common misunderstandings one by one, and hope you will understand. 1. “Doctor, I heard that perforation surgery is not clean for stones” is probably one of the most common questions. Many patients from surrounding counties and villages like to ask this question. These patients are not well educated, and they believe in the village doctor’s preconceptions. Laparoscopic surgery has become the gold standard at home and abroad, not only because of its minimally invasive nature, but also for the very important reason that its clear and magnified surgical field of view facilitates the surgeon to better identify tissue structures and thus better complete the surgery. It’s like driving an off-road vehicle with a large field of view and good visibility. Cholecystectomy is to take out the gallbladder and the stones inside the gallbladder together, so there is no question of stones not being done cleanly, it is just people’s uninformed imagination and misunderstanding. Remember: open cholecystectomy and laparoscopic cholecystectomy in the abdomen is the same operation process! 2. “Doctor, I got four holes punched in this operation, so it must not be done properly!” This is also a common misconception and patients and their families are dissatisfied and complain to the surgeon because of this. Generally speaking, in France and the United States, 4 holes are routinely punched in the patient’s abdominal wall, and you can see that the Run Run Run Shaw Hospital of Zhejiang University in Hangzhou (an American partner hospital) is also punched with 4 holes; while countries like Germany are used to punching 3 holes. So a few holes sometimes purely surgical tradition and custom, and 4 holes damage objectively only a little more than 3 holes, but there is the benefit of a clearer intraoperative vision. In our Wenzhou area, it is generally customary to have 3 holes, but in cases where the patient is obese, inflammatory, with multiple adhesions and congenital anatomical abnormalities, the doctor often adds an extra hole in order to have a clearer anatomical view and for the safety of the patient and less complications. 3. “Doctor, is it risky to do perforation surgery in the acute phase of cholecystitis?” Objectively speaking, it is true that the risk of laparoscopic cholecystectomy (LC) is higher than usual in the acute phase of gallbladder stones with cholecystitis. This is because the inflammatory edema and adhesions around the gallbladder are higher during the acute onset (which of course varies from person to person), often leading to serious complications such as unclear anatomy of the surgical area and sometimes accidental injury to the common bile duct and duodenum. But as I said earlier, LC has been developed for 30 years, and especially in the last 5 years laparoscopic techniques have developed rapidly. For a cautious laparoscopic surgeon with a lot of experience, the acute phase is not terrible and the operation is still safe. So it is crucial to find a good doctor for this kind of patients’ friends. 4, “to a small hospital to do the price is low, or to go to a small hospital to do, anyway, are perforation surgery” Many patients who are not well-off friends often have this mentality. I also understand this situation, after all, the income is not much, of course, less money to do more work best. But laparoscopic surgeons have to go through a long period of study and formal training before they can reach a certain level. This means that your surgery is given to such a doctor to do in order to reduce the risk to a minimum. In China, the public tertiary hospitals are still the most technically strong, both in terms of software (doctors) and hardware (medical equipment). Of course, in smaller hospitals, including private hospitals, there are also very good doctors, if you are lucky enough.