Although cholecystectomy is the definitive treatment for gallbladder stones today, and the superiority of laparoscopic cholecystectomy has been confirmed by many randomized controlled studies, epidemiology shows that the overall complication rate of cholecystectomy reaches 10%-15%. Moreover, modern medicine has found that the gallbladder has complex chemical and immunological functions in addition to storage and concentration of bile and contraction. Therefore, prophylactic surgery for asymptomatic gallbladder stones is questionable in terms of efficacy ratio. On the other hand German scholars have shown in bulk case studies that the incidence of cholecystitis and common bile duct stones increases significantly with the prolongation of gallbladder stone disease”. Since gallbladder stones are closely associated with gallbladder cancer, a regular follow-up approach to them seems undesirable. Cholecystectomy reduces the rate of surgical complications and removes stones to avoid the occurrence of cholecystitis and common bile duct stones. In recent years, the number of cases of fiberoptic choledochoscopic biliary lithotripsy has gradually increased, but there are still differences in the selection of indications and surgical methods. Indications: (1) Normal gallbladder function is a necessary condition for biliary lithotripsy. This can be reflected by the gallbladder wall being smooth and without significant thickening, and the two indicators of gallbladder contraction area greater than 30% after fasting and fatty meal as determined by ultrasound; (2) asymptomatic or with mild symptoms and a short history; (3) single gallbladder stones or multiple gallbladder stones with a small number and volume. Contraindications: gallbladder atrophy, acute inflammation, gallbladder wall thickening >0.4 cm, poor gallbladder contraction, partial or complete obstruction of the bile duct, coexisting stones in the bile duct, history of acute or chronic pancreatitis, gallbladder stones with polyp-like bulging lesions or suspected gallbladder cancer should be removed. Of course, the above indications are only a summary of the clinical experience of some centers, and there are still many controversies, lacking the support of large number of cases, multicenter and long-term follow-up results; moreover, the causes of gallbladder stones and stone recurrence are complex and not yet fully understood. Further clinical and basic research is needed.