Patient: I have recently had pain in my right upper abdomen once a week or so for an hour and a half before it gets better. It has been eight times. Ultrasound suggests that the gallbladder is 84*22mm in size, with a slightly hairy wall and multiple intense light clusters, the larger one 9mm, with body shadow, are seen within the cyst. The common bile duct was 8 mm and had a 5 mm hyperechoic protrusion attached to the inner wall with no body image and was inactive. The diagnosis is: gallstones, bile polyps and cholecystitis. Is my gallbladder still functional? Is it possible to undergo gallbladder preservation surgery? There are many large hospitals that recommend removing the gallbladder, is it difficult to operate or are gallstones prone to recurrence and do not favor gallbladder preservation surgery? Doctor: Generally speaking, biliary surgery is not advocated. Gallbladder preservation surgery was once popular, but now almost no one does it. For one thing, for patients who should have their gallbladder removed, most of them end up having a cholecystectomy, and the first surgery makes the second surgery more difficult and increases the risk; for another thing, for patients who can’t have their gallbladder removed, biliary surgery is often redundant and is basically a wasted knife. In your specific case, gallbladder stones, gallbladder polyps, cholecystitis, your gallbladder should be functional, but if you have frequent attacks, you should have surgery. Of course, if you feel that such attacks do not affect you greatly, there is no need to operate urgently, but in your case (multiple strong light masses are seen in the sac, the larger one is 9mm with acoustic shadow), it is estimated that you will end up with less than one knife; moreover, once the small stone in the gallbladder falls into the common bile duct through the cystic duct and causes obstruction, you may need emergency surgery. It is not advisable to perform biliary surgery. Biliary surgery itself is not much more difficult than cholecystectomy, but the recurrence rate is extremely high in patients who only have gallbladder stone removal surgery. Gallbladder stones in combination with gallbladder polyps have a potential risk of malignancy and removal of the gallbladder is advisable. Patient: According to some reports, there is a high chance of colon cancer with removal of the gallbladder, is that correct? And the tendency to develop intestinal polyps? Doctor: There are such reports, but they appear only after a decade or two. To save gallbladder for a few ten thousand points of chance, you have to suffer from gallbladder disease of recurrence and reoperation within 3 or 5 years, and reoperation is much more difficult and risky than the initial surgery, and often you end up not saving gallbladder. Therefore, no one in major hospitals does this kind of surgery. One more horrible danger for you: I’m afraid the risk of gallbladder cancer in patients with gallbladder stones is much more frightening than colon cancer in a few years! The one-year survival rate for gallbladder cancer …… is very low. Patient: One more question. The ultrasound suggests that my common bile duct is mildly dilated, is there a common bile duct stone? If so, will laparoscopy be converted to open surgery? Doctor: There are two disposal options for this case: 1. A preoperative MRI can show the condition of the common bile duct in a more visual way. If there are stones in the common bile duct, ERCP+EST can be done first, and then laparoscopic removal of gallbladder; or laparoscopic cholecystectomy and choledochotomy to remove stones; and direct open surgery. 2.Intraoperative imaging. If choledocholithiasis is found, direct laparoscopic choledochotomy for stone extraction and open surgery if necessary; or postoperative ERCP+EST (this option is not recommended), but in this way, if ERCP+EST fails, another operation will have to be performed. The exact operation will be agreed on a case-by-case basis.