How to find gallbladder stones, how to treat it, conservatively, or surgically, and if conservatively, what to treat if surgically, is it minimally invasive? Or open surgery? Should the gallbladder be removed? Or preserve the gallbladder? It is actually very simple. First of all, see if there are symptoms, if there are no symptoms or symptoms are relatively mild, you can first conservative treatment; if the symptoms are more serious, it is recommended to choose surgical treatment, please note: the following cases, although there are no symptoms, but still recommended for surgical treatment 1, stone diameter ≥ 2-3cm; 2, combined with the need for open surgery; 3, accompanied by gallbladder polyps > 1cm; 4, gallbladder wall thickening; 5, gallbladder wall calcification or porcelain gallbladder; 6, combined with diabetes; conservative how to treat? Do not eat greasy, do not drink, do not eat too much, eat less and more meals, and take appropriate cholestatic drugs. Quite simple a few, but to really do quite difficult. Then if surgical treatment? How to choose? Now the technology is advanced, whether it is bile preservation or bile cutting, generally choose minimally invasive surgery, less trauma, faster recovery, less pain. Minimally invasive surgery is not an option unless there are certain special factors (consult your physician for details). Should the gallbladder be preserved or removed? There is a certain amount of controversy, and experts in China and abroad are divided in their opinions. Experts who do not support gallbladder stone removal: 1. The main function of the gallbladder is to store and concentrate bile, and removal of the gallbladder does not significantly affect the quality of life of patients. 2. The causes of gallbladder stone formation are complex, and preserving the gallbladder can easily lead to stone recurrence. It has been reported that the recurrence rate of gallstones is as high as 40% to 50% within 5 years after gallbladder preservation and stone extraction. Expert opinion in support of gallstone preservation: 1. After gallbladder removal, a small number of patients may have symptoms such as diarrhea and decreased digestive function, which affect the quality of life of patients. 2. After gallstone extraction, the probability of stone recurrence can be less than 10% by changing the diet and cooperating with medication. What does the authoritative guideline say then? 1, which gallstone patients are suitable for gallstone extraction Diagnosed with gallbladder stones by ultrasound or other imaging examinations; normal gallbladder function confirmed by ECT examination or oral cholecystography; gallbladder not visualized by ECT examination, but able to remove the stones intraoperatively and confirm the patency of the gallbladder duct Patients who are able to accept the possibility of recurrence of gallstones. 2.Which patients are not suitable for biliary stone extraction? Those with gallbladder atrophy and disappearance of gallbladder cavity; those with stones in the gallbladder duct that cannot be detected by intraoperative endoscopy and cannot be removed; those with obstruction confirmed by intraoperative imaging of the gallbladder duct that cannot be lifted; those with diffuse intermural stones above Ⅲ° in the gallbladder; those with gallbladder wall thickness greater than 5mm; those with diffuse ro-Archis sinus stones or diffuse adenomyosis in the gallbladder wall; those with stenosis in the body of the gallbladder and separation holes less than 5mm.