In 1882, Langenbuch, a German physician, performed the world’s first open cholecystectomy and published the hotbed doctrine of gallbladder stone treatment: “The gallbladder should be removed not only because it contains stones, but also because it can grow stones”, and therefore the gallbladder should be removed, called ” hotbed doctrine”. This doctrine is the theoretical root of cholecystectomy for gallbladder diseases. With the development of laparoscopic technology, laparoscopic cholecystectomy with minimally invasive features has become the “gold standard” for the treatment of gallbladder stones and gallbladder polyps, and because of the widespread use of laparoscopic cholecystectomy, many surgeons currently adhere to this old academic viewpoint and take a pessimistic attitude toward gallbladder stone retrieval treatment. However, the gallbladder is an important organ of the human body, which has the function of storing concentrated and excreted bile and regulating the pressure of the bile duct. According to modern medical science, all organs that can be preserved should not be removed, and maximizing the function of the organ is truly minimally invasive. It is the common wish of patients and doctors to cure gallbladder disease without removing the gallbladder. In the past, scholars have tried Chinese medicine lithotripsy treatment for many years, but failed to achieve satisfactory results; they have also explored drug lithotripsy treatment, but failed to make breakthroughs; they have tried extracorporeal ultrasonic lithotripsy, but failed to achieve the same effect as urinary stone lithotripsy, so major hospitals have basically given up these kinds of gallbladder lithotripsy treatment. For patients with acute cholecystitis combined with gallbladder stones that are not suitable for surgical removal, sometimes an incision is made to remove the stones and a cholecystostomy is performed, which is a passive type of gallbladder preservation surgery. In recent years, the main purpose of gallbladder preservation is to preserve the function of gallbladder, and the active type of biliary surgery is to remove the stones by incision of gallbladder. Minimally invasive biliary stone removal is based on the assurance of removing gallstones, preserving the functional gallbladder and improving the patient’s quality of life, which is the embodiment of the development of modern biopsychosocial medical model and is more significant for the social significance of young and middle-aged patients. At present, there are various procedures of minimally invasive endoscopic biliary surgery, mainly small incision endoscopic biliary stone extraction (or polyp removal) method, laparoscopic-assisted small incision endoscopic biliary stone extraction method and complete laparoscopic endoscopic biliary stone extraction method. The choice of the specific procedure depends on the specific situation of the patient, the surgeon and the hospital. Our hospital mainly performs complete laparoscopic choledochoscopic biliary stone retrieval, which has a wide range of surgical indications and can be performed even with a high gallbladder location, with high technical requirements, easy operation and minimal trauma. Gallstone disease has become such a socioeconomically relevant medical problem that it is clearly not a problem that can be completely solved by surgical resection. A series of adverse effects, such as medically induced biliary tract injury, immune deficiency and increased incidence of colorectal cancer and common bile duct stones after cholecystectomy, cannot be avoided by clinicians. Traditional surgery regards cholecystectomy as the gold standard for the treatment of gallbladder stones and gallbladder polyps, and the gallbladder is easily removed, and there is still too much ignorance about the lack of refined research on the gallbladder for more than 100 years. In 2007, Academician Huang Zhiqiang proposed “to pay attention to the exploration and research of gallbladder function; to apply new high-tech technologies to explore the treatment of gallbladder stones and gallbladder polyps”; the late Academician Qiu Fazu, the late master of surgery, supported “endoscopic minimally invasive biliary stone extraction (polyps)” and emphasized that we must “pay attention to the function of the gallbladder, play the role of the gallbladder, and protect the existence of the gallbladder”. This is the root cause of many experts’ disapproval of biliary preservation treatment. However, there is a fundamental difference between the new biliary lithotripsy treatment and the old biliary lithotripsy treatment. The new biliary lithotripsy procedure is operated under choledochoscope, which overcomes the blind spot of surgery and takes many measures to prevent recurrence, such as combining with postoperative health care treatment such as cholestasis, the recurrence rate will be significantly reduced. For different patients with gallbladder stones, the degree of gallbladder stones and their comorbidities are different, and how to weigh the pros and cons and choose correctly is the key to benefit in the end. It has been proved that some gallbladders cannot be salvaged and must be removed, otherwise they may bring some complications to the patients and cause more losses, so it is very necessary to define the scope of indications for biliary preservation surgery for the development of biliary preservation surgery. At present, the indications for minimally invasive biliary surgery are: gallbladder stones and gallbladder polyps with evidence of gallbladder function or recovery of gallbladder function after lithotripsy; patent common bile duct and cystic duct; and clear requirements for biliary preservation. However, minimally invasive cholecystectomy is contraindicated in the following cases, and the gallbladder must be removed: limited thickening of the gallbladder wall without excluding gallbladder cancer; tumor polyp of the gallbladder with pathology suggesting severe atypical hyperplasia or confirmed cancer; atrophic cholecystitis; porcelain gallbladder; gallbladder stone induced acute purulent or gangrenous cholecystitis, acute pancreatitis or other serious complications; obstruction of the cystic duct or common bile duct, which cannot be released immediately Patients who have had most of their stomachs removed, or after gastrojejunostomy; those who have had poor results with diabetes. Therefore, in addition to choledochoscopy and laparoscopy, units performing biliary preservation surgery must also be equipped for rapid frozen section pathology. Intraoperative ultrasound or cholangiography equipment is also required, if necessary, to ensure the effectiveness of biliary preservation surgery. Annual follow-up after surgery is advisable, with repeat ultrasound to monitor the recurrence of stones or polyps and to determine the long-term outcome. Postoperative protection of gallbladder function and promotion of gallbladder function recovery is an important measure to avoid recurrence of postoperative stones and polyps, and is a systematic project that requires long-term adherence. We adopt a combination of Chinese and Western medicine to guide the postoperative “gallbladder protection”, including changing the preoperative bad habits and diet structure, and giving biliary drugs and physiotherapy when necessary to protect the gallbladder function or promote the recovery of gallbladder function to avoid the recurrence of stones or polyps.