Primary gallbladder cancer is the most common malignant tumor of the biliary tract, and its incidence has increased in recent years, and it is gradually gaining attention because of its poor prognosis. Although surgical techniques have been advancing and developing in the past 30 years, the prognosis of gallbladder cancer is extremely poor because of its high malignancy, late appearance of clinical symptoms, difficulty in early diagnosis and early detection, high preoperative misdiagnosis rate and low curative surgical resection rate. Most of the gallbladder cancer patients who can survive for a long time after surgery are early cancer patients unintentionally discovered during gallbladder surgery. Therefore, early detection, early diagnosis and reasonable surgery are the keys to improve the survival rate of gallbladder cancer after surgery. How to detect gallbladder cancer at an early stage? The diagnosis of gallbladder cancer is still lack of specific tumor markers and mainly relies on imaging diagnosis. In recent years, with the wide application of ultrasound, CT, MRI and ERCP, the diagnosis rate of gallbladder cancer has been improved, but the early diagnosis rate is still low. B-mode ultrasound and CT are the most commonly used examination methods, but sometimes the rate of diagnosis and surgical detection is very low because the results of imaging diagnosis, especially B-mode ultrasound, are highly dependent on the experience of the examiner. The busy working conditions of outpatient clinics and the lack of vigilance of examiners in the diagnosis of gallbladder cancer may lead to missed diagnosis and misdiagnosis. Therefore, it is an important way to improve the early diagnosis by strengthening the education on the vigilance of gallbladder cancer diagnosis. It is of great clinical significance to pay attention to the follow-up of gallbladder cancer in high-risk groups, which can be expected to detect early cases. Which patients are the high-risk group of gallbladder cancer? The main ones are: 1, age >55 years; 2, definite biliary tract disease with a long history of >5 years; 3, right upper abdominal pain changing from intermittent to persistent; 4, gallbladder stones >2.5 cm; 5, ultrasound suggesting atrophy, calcification, local thickening, ceramic-like gallbladder; 6, gallbladder polyps >1.0 cm in diameter; 7, adenomyosis of gallbladder; 8, pancreaticobiliary duct confluence malformation; 9. previous cholecystostomy. Patients with the above conditions should be considered as high-risk patients for gallbladder cancer and need to be further examined and closely followed up. How to standardize treatment for gallbladder cancer patients? What should be done once gallbladder cancer is diagnosed or highly suspected? 1.Surgical treatment: Early-stage gallbladder cancer used to be considered to be treated by cholecystectomy, but now most scholars support that early-stage gallbladder cancer should also be treated by radical surgery. Expanded cholecystectomy should be performed for middle and late stage gallbladder cancer, which means to expand the gallbladder and the surrounding 2cm liver tissues, and to clear the lymphatic drainage area around the gallbladder, such as portal vein, hepatic artery and extrahepatic bile duct, so that no cancer remains in the cut edge. If there is local invasion of the liver, corresponding lobectomy or even multi-lobe resection of the liver can be added. For advanced gallbladder cancer with extensive intrahepatic metastases, metastases that are too large or invade the hilum, liver metastases combined with extensive metastases from other organs, poor general condition that cannot tolerate hepatectomy or combined with hepatic sclerosis that cannot be surgically resected, hepatic artery chemoembolization via femoral artery puncture and percutaneous ultrasound guided anhydrous alcohol injection are feasible. For various obstructive jaundice caused by combined hepatic hilar or distal bile duct invasion, various forms of drainage should be actively adopted; if there is pyloric obstruction, gastrojejunostomy should be performed to reduce the patient’s pain and improve the quality of survival. 2.Radiotherapy: In order to prevent and reduce local recurrence, radiotherapy as adjuvant treatment for gallbladder cancer can improve five-year survival rate. Radiotherapy for gallbladder cancer includes external irradiation, intraoperative radiotherapy and brachytherapy. There is no accepted chemotherapy regimen that can effectively control gallbladder cancer, but 5-FU-based combination chemotherapy FAM (5-FU, adriamycin and mitomycin) is effective up to 30% in the treatment of gallbladder cancer. Recent studies have found that the emerging antitumor drug Kenzer combined with 5-FU or cisplatin has synergistic effects without superimposed toxic effects, and the overall remission rate of those treated with the combination chemotherapy is 60%, which is the best reported efficacy so far. 3.Other: In addition to the above treatments, patients with gallbladder cancer can also apply immunotherapy and traditional Chinese medicine. Immune enhancers such as interferon, interleukin and thymidine can improve the immunity of the body, improve the condition, prolong the survival period and improve the quality of life. Chinese herbal medicine treatment can reduce the toxic side effects of chemotherapy and radiotherapy, improve the immunity of the body, strengthen the body and improve the efficacy of treatment by helping to dispel the evil and harmonize the spleen and stomach.