The prevalence of gallstones in China is about 8%, especially in women over 40 years old, obese and with multiple pregnancies. According to another survey, about 20% of people over 60 years old in Shanghai have gallstones. In what cases do gallstones require surgical treatment? There are many treatment methods for gallstones, but the decision of what treatment method to use, when surgery is necessary, and when to choose surgery is not up to the patient or the doctor’s subjective will, but should be considered according to the objective and specific condition. At present, the most effective method for gallbladder stones is cholecystectomy. Nowadays, the most widely carried out surgical method at home and abroad is laparoscopic cholecystectomy, which has the advantages of less trauma, less pain, faster recovery, safety and fewer complications, and has basically replaced the traditional open cholecystectomy. The indications for gallbladder stone surgery include the following 10 indications: 1) large gallbladder stones with symptoms, with a diameter of more than 1 cm; 2) multiple gallbladder stones; 3) gallbladder stones with polyps in the gallbladder; 4) gallbladder stones with acute pancreatitis; 5) gallbladder that has become smaller, with thickened walls or no bile in the gallbladder on ultrasound, suggesting that the gallbladder is no longer functional; 6) gallbladder stones in the gallbladder that block the outlet. Gallbladder stones have blocked the outlet and the gallbladder has been enlarged; 7. Acute complications of gallbladder stones, such as acute cholecystitis, pus accumulation in the gallbladder or gallbladder perforation; 8. Gallbladder stones complicated by chronic cholecystitis or with recurrent attacks; 9. Gallbladder stones combined with common bile duct stones or obstructive jaundice; 10. Gallbladder stones suspected to be gallbladder cancer. The above cases are not absolute and should be decided according to the patient’s specific situation and needs. For example, in elderly patients, if they are in poor physical condition and have other serious heart and lung diseases, and the risk of surgery is high, the pros and cons of surgical treatment should be carefully analyzed, and the most suitable treatment plan should be determined for the patient under the full communication between the doctor and the patient. What is the danger of not treating asymptomatic gallstones for a long time? Many patients suffer from gallstones for more than 10 years, because the symptoms are not serious, they have not been treated. Unbeknownst to them, the length of time of suffering from stones is also related to the occurrence of gallbladder cancer. The long-term existence of gallbladder stones will cause gallbladder atrophy and calcification, and gallbladder cancer will occur in 20% to 60% of patients with calcified gallbladder or porcelain-like gallbladder. Therefore, although asymptomatic gallbladder stones have no obvious spontaneous discomfort, they are not harmless to the human body and regular review is recommended, and patients with asymptomatic stones still need surgery if necessary. In addition, for patients with multiple small gallbladder stones, the stones can easily get stuck in the gallbladder duct or fall directly into the common bile duct, causing an attack of acute cholecystitis or causing obstructive jaundice. Therefore, for patients with multiple small gallbladder stones, especially those with hypertension and diabetes (hypertension can be aggravated when the gallbladder is inflamed, and patients with diabetes have poor resistance to infection and once the infection is inflamed the infection cannot be easily controlled), surgery is recommended.