With the improvement of people’s living standards and changes in dietary structure, gallbladder stones and gallbladder polyps are gradually increasing, and their incidence is also increasing year by year. Some of them are combined with cholecystitis and have obvious symptoms and are very painful; others have good gallbladder function and no discomfort. After examination or consultation, some of them are very worried and are in danger, while others do not take it seriously and do not pay attention to it. What should be done? Many patients in the clinic are very torn, seeking medical help and consulting everywhere, not knowing what to do. Especially at present, there are many medical institutions and hospitals specializing in the treatment of gallbladder diseases have emerged and advertise “gallbladder stone removal” and “gallbladder polyp removal”, so there is a mixture of good and bad, resulting in patients with gallbladder lesions wanting to cure and preserve their gallbladder. It is very difficult for them. There is no need to worry, as most of them will be treated correctly and appropriately as long as they are treated according to medical principles. In this case, stones and polyps must be treated separately. Gallbladder stones are more common than gallbladder polyps, and the principles of gallbladder stone management are: 1. If there are no symptoms, especially in young patients (under 35 years old), and the gallbladder is functioning well, you can follow up and observe, and review the ultrasound every 3-6 months. 2, although asymptomatic, but the stone is greater than 2.5cm, gallbladder wall increase, sometimes combined with calcification, age greater than 50 years old, can consider preventive removal of gallbladder. 3, there are symptoms that combined with cholecystitis, generally non-specific digestive symptoms, such as indigestion, epigastric support, aversion to grease, fatty meals or alcohol consumption aggravated; if the stone is embedded in the gallbladder neck or gallbladder duct, it will cause symptoms of acute cholecystitis: severe pain in the right upper abdomen, nausea, vomiting, fever and jaundice. Those who usually do not feel anything but have caused acute pancreatitis. All these cases need surgical treatment. 4. Those who have non-functional gallbladder and conservative treatment is ineffective must undergo cholecystectomy. The function of the gallbladder can be determined by ultrasound examination. If the gallbladder is functional, conservative treatment can be tried, and all kinds of litholytic and cholagogic drugs have certain efficiency, but the cure rate is low, and stone residue is more common, and even if it is completely eliminated, it is often easy to recur, and the recurrence rate is often more than 50% within 5 years. 6. Preserving the gallbladder and simply removing the stones, i.e. gallbladder incision and stone extraction, is only suitable for particularly young people, under 30 years old, with good gallbladder function and symptoms. However, after stone removal, because gallbladder stones often have an individual anatomical etiology, i.e., abnormal gallbladder development, many patients recur several years later and eventually undergo cholecystectomy. The incidence of gallbladder polypoid lesions is about 5%, more in men than in women, and correlates with gender, gallstones, alcohol consumption, body surface glucose tolerance, and blood lipids. The pathological classification is divided into two categories: non-neoplastic and neoplastic, and the latter is divided into benign and malignant. Among the non-neoplastic lesions, cholesterol polyps are the most common, followed by inflammatory polyps, adenomatous hyperplasia, adenomyoma and so on. Among the neoplastic polyps, adenoma and benign mesenchymal tissue tumor are the most common benign ones, while malignant ones are gallbladder cancer. The principles of treatment are: 1, diameter less than 1. 0cm multiple, with a tip, not combined with stones of the gallbladder polyp-like lesions can be suspended surgery, but need regular follow-up; 2, diameter of less than 1. 0cm, single, broad-based, combined with stones can be considered for surgery; no stones and no symptoms, but follow-up found to have a tendency to increase, should also be actively surgical treatment; 3, diameter of large 1. 0cm, single, broad-based, age greater than 50 years, combined with stones, In principle, surgery should be performed if the gallbladder wall is thickened, and histopathological examination should be performed. 4. For benign PLG, some scholars have proposed the treatment method of removing polyps only to preserve the function of the gallbladder while preserving the normal gallbladder, which has not been universally accepted. So in which cases can bile be preserved? There are still some clinical centers that have reported the feasibility of biliary preservation. The prerequisite for biliary preservation is a functioning gallbladder. If a non-functioning gallbladder is preserved, not only is there no benefit, but there is also the disadvantage of causing acute cholecystitis, acute pancreatitis, and gallbladder cancer. How to determine whether the gallbladder is functioning well or not? First, the usual symptoms, if there is no discomfort under normal diet, or after a full meal or high-fat meal, there is no discomfort or abdominal pain; second, the method of ultrasound examination is used: measure the volume of gallbladder on an empty stomach, and then measure the gallbladder 40 minutes after eating a high-fat meal, if the volume of gallbladder is reduced by more than 50%, it means that the gallbladder contraction function is good. Thirdly, ultrasound examination of the gallbladder wall is smooth and the wall thickness is <3mm. The second prerequisite for gallbladder preservation is that it will not cause other lesions or recurrence of the original lesions after gallbladder preservation. In the case of wide basal polyps, biliary preservation is sometimes incomplete, which can easily lead to recurrence or cancer; moreover, if part of the gallbladder wall is sutured again, the gallbladder morphology and contractile function will be affected, and the possibility of recurrence of gallbladder stones and cholecystitis will increase. Gallbladder adenomyosis is a precancerous lesion and should not be bile preserved. Currently some hospitals have done biliary preservation surgery and the reported recurrence rate is not as high as in foreign studies decades ago, one of the main reasons is to do some asymptomatic gallbladder stones, and the principle of these patients is to observe without special treatment, because many patients may not have cholecystitis in their lifetime although they have stones. We have often come across cases in our clinic where we have done gallbladder preservation surgery in outside hospitals and had to perform a second cholecystectomy because of intra-biliary hematoma, recurrence of stones, unrelieved cholecystitis, right upper abdominal distension and discomfort and other preoperative symptoms still existed. Therefore, there is no need to be torn between gallbladder preservation and gallbladder removal. First of all, it depends on whether the gallbladder stones or polyps need to be treated or not; if they do not need to be treated, there is no such problem, just observe them regularly. If the gallbladder function is normal and the inflammation of the gallbladder is not obvious, it is possible for young patients to have gallbladder preservation surgery on a trial basis, but the prerequisite is that they must be prepared to have their gallbladder removed again in case of recurrence.