Cholecystectomy has been performed for more than 100 years. From clinical observation, although the function of concentrating and storing bile in the gallbladder is lost after cholecystectomy, it has no significant effect on the digestion and absorption function of the vast majority of patients. In some patients, the gallbladder has already lost its function before resection, and the liver has been working in place of the gallbladder for a long time. So for these patients, the digestive function will be better after the surgery when the lesion is gone from the body. Although there are complications associated with cholecystectomy, and even an increased incidence of colon cancer has been reported, there is as yet no evidence from evidence-based medicine to prove this. Cholecystectomy is still recognized as a safe and effective treatment for gallbladder disorders. Many physicians strongly advocate cholecystectomy, in which the gallbladder is cut open to remove the stone and the gallbladder is preserved. Many patients think that biliary preservation is a new technology and feel that it is definitely better than cholecystectomy. In fact, this is not absolutely true. First of all, the recurrence rate of gallbladder stone preservation in domestic and international literature is still not low, and not all gallbladder stones are suitable for gallbladder stone preservation. Some experts even say that blind gallbladder preservation is equivalent to leaving a lesion in the body, just like planting a time bomb. For example, a patient who had gallbladder stones for more than 10 years had a 6 mm thick gallbladder wall and a shrunken gallbladder cavity, but she insisted on gallbladder-conserving surgery. After surgery, she still had pain in the right upper abdomen and lost weight, and was hospitalized again. Therefore, the decision of biliary preservation or biliary excision ultimately depends on the patient’s condition. Who must undergo cholecystectomy? If the gallbladder has atrophied, has lost its function, or has the possibility of malignant transformation, removal is the only option. For example, gallbladder removal is required for acute attacks of stone cholecystitis, atrophic cholecystitis, thickened gallbladder wall (porcelain gallbladder), loss of gallbladder cavity, and gallbladder polyps with suspected malignancy or high possibility of malignancy. For patients with hemolytic anemia combined with gallbladder stones and diabetic patients combined with gallbladder stones are not suitable for cholecystectomy. Gallbladder surgery is also not recommended for elderly people with a long history of gallbladder stones or those with cardiovascular disease. Who can undergo biliary surgery? The following 3 points must be met when choosing biliary surgery: 1. Patients who are young in age and who request and agree to biliary preservation. 2. Ultrasound and MRCP examination show that the mucosa of the gallbladder is smooth, the thickening of the cyst wall is not obvious, and the gallbladder can be preserved if the gallbladder fills well. In other words, the gallbladder should be functional in order to be preserved. If the gallbladder is already full of stones and the gallbladder is non-functional, the gallbladder should still be removed. 3. During the surgery, the gallbladder duct should be checked after the stones are removed, and if the duct is not open, the gallbladder cannot be preserved either. In addition, the current gallbladder surgery is also used in the treatment of gallbladder polyps, about the standard of gallbladder polyp surgery, there is no specific standard, some people fear polyps cancer, that as long as the polyps are found to be operated, which is not true, most of the general gallbladder polyps are cholesterol polyps, rarely cancerous, no need to be nervous. It is generally believed that 1cm is the approximate limit, and polyps above 1cm can be removed to preserve the gallbladder or direct cholecystectomy. 1cm or less can be closely observed, and surgery can be considered if it grows rapidly in a short period of time or accompanied by obvious symptoms such as abdominal pain. In addition, the decision of whether to remove the gallbladder is mainly based on the immediate intraoperative pathology, if it is malignant, then the gallbladder will be removed, and vice versa, the gallbladder can be preserved. Gallbladder stone preservation surgery, is there any recurrence after surgery? This is a key question. Preserving a functional gallbladder and striving to cleanse the gallbladder of stones is the goal of gallbladder preservation surgery. However, since the cause of stone formation is not fundamentally controlled, there is still a possibility of recurrence. In other words, we can only remove the stones that have grown in the gallbladder through surgery, but because the structure of bile in the gallbladder is different for each person, some people have a high proportion of cholesterol in the bile, and cholesterol is easily deposited in the gallbladder to form stones, so for such patients, even if the stones are removed, new stones will still grow in the future. The recurrence rate of stones 1-5 years after lithotomy is about 2%-9%.