Gallstone disease includes gallbladder stones and common bile duct stones, which differ in their development and evolution, as well as in the risk they pose to the body. Stones that originate in the gallbladder can cause inflammatory reactions such as mucosal congestion, edema, inflammatory cell infiltration and ulceration, which can lead to non-specific symptoms such as epigastric fullness, belching, dyspepsia and clinical symptoms such as epigastric pain, dull pain, distension or colic. The movement and friction of gallstones and stimulation of the gallbladder can cause severe pain in the bile duct, while the damage to the bile duct mucosa can easily cause bacterial infection and acute and chronic cholecystitis. Inflammatory edema, stone impaction and obstruction at the gallbladder neck and cystic duct can cause acute swelling and fluid accumulation in the gallbladder and induce acute cholecystitis, which can be accompanied by continuous severe pain and paroxysmal colic, fever, nausea and vomiting, and in severe cases, can lead to gallbladder perforation and diffuse peritonitis and shock. Larger stones located in the abdomen of the gallbladder can cause jaundice by compressing the common bile duct, leading to liver function impairment. The chronic stimulation of gallbladder mucosa or obstruction of gallbladder duct by gallbladder stones can lead to mucosal hyperplasia, thickening of gallbladder wall, and impairment of its function of concentrating and storing bile as well as gallbladder contraction, which not only causes serious impairment of digestive function, but also causes gallbladder cancer. Gallbladder stones are combined with gallbladder cancer in 50-70% of patients. Smaller gallbladder stones can enter the common bile duct through the cystic duct and become secondary common bile duct stones. Stones located in the common bile duct or common hepatic duct can be primary stones, secondary to gallbladder stones or formed by intrahepatic bile duct stones falling in. The movement of stones in the common bile duct or common hepatic duct can lead to chronic inflammation of the common bile duct, i.e., cholangitis. When gallstones accumulate or become embedded in the lower end of the common bile duct causing obstruction of the common bile duct, it can cause dilatation of the common bile duct and obstructive jaundice. Since the lower end of the common bile duct and the pancreatic duct open together at the posterior wall of the duodenum, the repeated stimulation of stone discharge can cause edema and obstruction at the opening of the pancreatic duct, leading to acute pancreatitis. Pancreatitis can recur and produce pancreatic duct stones, pseudopancreatic cysts, diabetes mellitus, steatorrhea and dyspepsia. Stones located in the marginal parts of the liver, i.e., small branches of the bile ducts, can be asymptomatic in the early stages. The chronic irritation and obstruction of stones cause inflammation of the bile ducts, which may spread to the adjacent bile ducts and form ulcers after the bile duct endothelium is damaged. Bacterial infection of the bile duct, bile sludge, and gallstones interact with each other to develop stones. When stones obstruct larger branches of the bile duct, the liver tissue at the drainage site becomes swollen, degenerated, fibrous hyperplasia and dysfunctional, thus accelerating the pathological evolution of the local liver tissue and biliary system caused by gallstones. The clinical symptoms of biliary pain and digestive dysfunction can gradually appear at this time. When stones cause acute obstruction of larger bile ducts such as hepatic segment or lobe, it may lead to acute biliary duct expansion above the obstruction and cause acute cholangitis, which may manifest clinically as severe biliary pain, fever, hepatomegaly and liver function impairment. When stones obstruct both the left and right hepatic ducts, in addition to the aforementioned symptoms, obstructive jaundice may occur and liver damage will be more severe. The obstruction of bile ducts and bacterial infection may lead to purulent cholangitis and liver abscess. When gallstones obstruct the larger bile ducts for a long time, the upper part of the obstructed bile ducts will dilate and bile will accumulate, which may cause biliary cirrhosis and liver atrophy. Biliary cirrhosis can cause clinical symptoms of portal hypertension such as ascites, splenomegaly, hypersplenism, esophagogastric fundic varices and upper gastrointestinal bleeding. Long-term chronic stimulation of bile duct stones and infection can cause destruction, regeneration, differentiation and atypical proliferation of bile duct epithelial cells to induce carcinogenesis. Cholangiocarcinoma can be combined with gallbladder stones and intra- and extra-hepatic bile duct stones, and the rate of concomitant occurrence is 16.9%. The incidence of cholangiocarcinoma is 1.2%~9.7%, and some stones are found after several years or more than ten years. The sites of tumor occurrence mostly coincide with the narrowing sites of the bile duct or the sites of stones. It indicates that gallstones are closely related to bile duct cancer and are an important factor leading to cancer.