I would like to say a few words about the so-called biliary surgery, because I am often asked this question by patients in my daily work. It is not a new technique, but an old-fashioned emergency solution for critical patients who cannot tolerate a full cholecystectomy for a long enough time, and is generally used only in the last resort: for example, if the patient is critically ill and cannot tolerate a normal operation, the stones must be removed in the shortest and simplest time to release the obstruction and save his life (I just treated such a patient recently). Therefore, in any regular hospital, bile preservation surgery is not recommended for general stone patients. However, some irregular hospitals will use the concept of “gallbladder preservation” to attract patients (because the so-called gallbladder preservation surgery is much simpler and less risky than gallbladder removal, but the charges are the same as the latter, so why not?) The existing theory is that the formation of gallbladder stones is closely related to the internal environment of the gallbladder, and if the stones are only removed, their recurrence is almost inevitable, and at most the time of recurrence is different. Patients who want to undergo cholecystectomy are afraid that having less gallbladder will have an impact on their future life, but in fact, there is no need to worry too much. Cholecystectomy began in 1882, which means that this surgical method has been tested for more than 120 years! From a worldwide perspective, people have their gallbladders removed almost every day. I have seen many doctors on the internet supporting cholecystectomy and presenting what they call “newer theories”, but for such a “new” technique, the most recent articles listed are from the 80’s. If patients are interested, they can ask the following questions Have the theories presented been unanimously accepted nationally and internationally? Have they tracked the recurrence rate of patients after choledocholithotomy? Have these “new” and “good” theories been discussed at recent international hepatobiliary conferences and benefited the whole world (not only the Chinese population)? I once attended a prospective research meeting trying to do a biliary surgery (that is, part of the biliary surgery, part of the conventional resection, and then a follow-up comparison), at the meeting, a doctor who claimed to do the first biliary surgery in a city hospital (at that time also had various newspaper publicity) confessed that now their hospital no longer do this surgery, the recurrence rate is too high. Another doctor from a smaller hospital said: “The recurrence rate in our hospital is very low. A professor from the next tertiary hospital said: You are XX hospital, right? I believe your recurrence rate is very low because they all went to our hospital to have their gallbladders cut. In the end, this meeting was not concluded. From a scientific point of view, I never fully believe that gallbladder preservation for stone removal is nonsense. Perhaps in the future, with advances in medical technology and increased awareness, gallbladder preservation for lithotripsy may become the gold standard. But in the present, we must be honest with our patients about what the accepted methods are for gallbladder stone management and what the pros and cons of the new methods are. Whenever a patient asks me if biliary stone extraction is possible, my answer is: technically I have no problem at all, but the recurrence rate is very high, so if you don’t mind having another surgery after a recurrence I can do it for you.