The necessity of surgery for gallstones 4 mm is determined by the patient’s presentation, the condition of the gallbladder and the infection. Gallstones are mainly categorized into gallbladder stones, intrahepatic bile duct stones and extrahepatic bile duct stones. 1. Asymptomatic gallbladder stones generally do not require surgery; cholecystectomy is preferred for symptomatic patients (e.g., biliary colic, etc.) or those with complications. Surgery should be considered for those with calcification of the gallbladder wall, accompanied by ≥1cm gallbladder polyps, thickening of the gallbladder wall (>3mm), or chronic cholecystitis. 2. Asymptomatic intrahepatic bile duct stones can be left untreated with regular observation; those with recurrent symptoms (e.g. chills, high fever, abdominal pain) should be selected for surgical treatment. 3. Extrahepatic bile duct stones: generally, surgical treatment is the mainstay of treatment, and most of the choices are choledochotomy for stone removal and T-tube drainage. 4mm gallstones, if the above surgical indications occur, need to actively cooperate with professional doctors to perform surgical treatment.