To explore the surgical treatment of moderately advanced gallbladder cancer (Nevin stage III-V) and further improve the survival time of patients. METHODS: Combined with the literature, the perioperative clinical data and follow-up data of our group of 17 cases of intermediate to advanced gallbladder cancer were discussed in relation to the preoperative diagnosis, surgical treatment strategy, postoperative complications and survival time of patients. RESULTS: Through multiple preoperative imaging data corroborating each other, it is possible to diagnose and judge the stage of middle and advanced gallbladder cancer, but misdiagnosis cannot be avoided; the key point of surgical treatment of middle and advanced gallbladder cancer is to determine the scope of surgery, especially the degree of complete lymph node dissection. If necessary, the scope of surgery can be expanded appropriately; postoperative complications mainly include abdominal infection, biliary fistula and paralytic intestinal obstruction. Conclusion: The surgical treatment of intermediate and advanced gallbladder cancer requires appropriate surgical scope, and the absence of intraoperative tumor residue can enable patients to survive for a longer period of time.