Gallbladder stones are a common surgical condition. Laparoscopic cholecystectomy has become the gold standard of gallbladder stone treatment, but it cannot preserve gallbladder function. Cholecystectomy for the treatment of gallbladder stones from the perspective of preserving gallbladder function is theoretically justified, but a large amount of higher-level clinical evidence is needed to verify its feasibility. At present, epidemiological investigations on the long-term complications of cholecystectomy and prospective studies on biliary stone extraction should be carried out to verify the advantages, disadvantages and indications of each with evidence-based medical evidence. We also oppose the removal of gallbladder if gallbladder stones are present, and we oppose the blind biliary stone extraction regardless of the indications. The purpose of these studies and explorations is to find a treatment method that is widely indicated, noninvasive or minimally invasive, with clear efficacy, low recurrence rate, and few complications, while preserving gallbladder function as much as possible. Unfortunately, however, a treatment method that fully meets these criteria has not been found. Oral lithotripsy, perfusion lithotripsy, extracorporeal shock wave lithotripsy, and percutaneous cholecystolithotripsy with lithotripsy all start with the aim of removing stones and preserving the gallbladder. However, these treatments have narrow indications, certain requirements on the nature, number and size of gallbladder stones, longer treatment courses, and certain side effects of oral lithotripsy drugs themselves. Lithotripsy treatment, especially extracorporeal lithotripsy, can cause mechanical damage to adjacent organs, and lithotripsy must be combined with stone removal, which may induce complications such as acute cholangitis and pancreatitis during stone removal. In addition, these treatments are associated with the problem of recurrence of gallbladder stones. The average rate of stone regeneration after lithotripsy and lithotripsy is 10% per year, with a cumulative recurrence rate of 50% in the first 5 years and 83% in the 15-year follow-up. Since the introduction of laparoscopic cholecystectomy, it has gradually replaced all other treatments as the gold standard for gallbladder stone treatment because of its minimally invasive nature, few complications, broad indications, clear efficacy, and absence of gallbladder stone recurrence. In addition, in the study of the causes of gallbladder stones, a theory that can fully explain the causes of gallbladder stones has not yet been found, resulting in no substantial progress in non-surgical treatment methods such as lithoprevention and lithotripsy. Therefore, laparoscopic cholecystectomy is now considered to be the best option for the treatment of symptomatic gallbladder stones. In the historical evolution of gallbladder stone treatment, the various methods of removing stones and preserving the gallbladder were eventually replaced by laparoscopic cholecystectomy because, although laparoscopic cholecystectomy has complications, its overall advantages of minimal invasiveness and few complications overcame the disadvantages of other treatment methods of long duration, narrow indications, many complications, and high recurrence rate. Therefore, even for gallbladder stones with good gallbladder function, we have to sacrifice the gallbladder in the treatment to obtain a stable outcome. Although laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallbladder stones, there are always complications and surgical risks associated with any surgery, especially the complications of bile duct injury, which are often disastrous for the patient. According to bulk case statistics, the incidence of vascular injury in laparoscopic cholecystectomy is 0.2%, the incidence of bile duct injury is 0.2% to 0.8%, and the incidence of intestinal duct injury is 0.07% to 0.87%. More importantly, surgical removal of the gallbladder, although avoiding the recurrence of gallbladder stones, also brings problems caused by the loss of the gallbladder. After gallbladder removal, the patient loses the function of concentrating, storing and discharging bile from the gallbladder, causing the body to be unable to provide enough bile when eating, especially when eating high-fat and high-protein foods, so the incidence of indigestion, bloating and diarrhea in patients increases significantly. Some scholars believe that after cholecystectomy, the incidence of bile stones in the common bile duct increases due to compensatory dilatation of the common bile duct, resulting in the relative narrowing of the terminal opening of the common bile duct and changes in the fluid mechanics of bile in the common bile duct. After cholecystectomy, the incidence of reflux esophagitis and inflammation of the stomach and duodenum is significantly higher in some patients. In addition, the gallbladder mucosa has certain secretory and immune functions, and removal of the gallbladder will have certain effects on the immune defense function of the biliary tract. The primary bile acids secreted by the liver after gallbladder removal are continuously excreted to the intestine, and secondary bile acids are produced by the action of Escherichia coli. Increased secondary bile acids and increased number of enterohepatic cycles tend to lead to abnormal intestinal mucosal proliferation, which may lead to increased incidence of colon cancer. As seen above, laparoscopic cholecystectomy has become the gold standard for gallbladder stone treatment only relatively. The advantages are minimally invasive and no recurrence of gallstones, but its removal of the gallbladder deprives the patient of gallbladder function, and there are certain surgical complications, especially the problem of bile duct injury. Therefore, laparoscopic cholecystectomy is not yet a truly ideal treatment for gallbladder stones. More than 50% of patients will have a recurrence of stones within 5 years after stone extraction. Even with preoperative screening, the recurrence rate of stones 5 years after surgery is still high at 39.6 to 41.6% for only functional gallbladders undergoing cholecalculotomy. In the past, the reason for the high recurrence rate of biliary stone extraction was that the stones were not removed, and a large part of recurrence was actually residual stones. The treatment concept of biliary lithotripsy is to maintain the integrity of the human organ, in line with the concept of more minimally invasive, with fewer complications than cholecystectomy, especially the possibility of bile duct damage, while preserving the physiological function of the gallbladder, and its therapeutic indications are wider than lithotripsy and lithotripsy. Its concept is reasonable. If its efficacy is confirmed, it should be a better treatment for gallbladder stones than laparoscopic cholecystectomy. Even if there is a certain recurrence rate of gallbladder stones with cholecystectomy, it has considerable clinical application value if it is not recurring within a short period of time.