In recent years, with the continuous improvement of the living standard of our people, the prevalence of benign gallbladder diseases (mainly gallbladder stones) has been increasing, and I have already described the problems related to gallbladder stones in another article, so I will not repeat them here. Chronic inflammation of the gallbladder and some adenomatous polyps of the gallbladder have a certain chance of becoming cancerous, especially in women with diabetes mellitus, the chance of gallbladder cancer is higher and should be taken seriously. Driven by economic interests, some techniques that have been eliminated abroad, such as biliary lithotripsy, have a tendency to resurface in China. Today, we focus on what patients should do when they have gallbladder cancer. In clinical practice, the diagnosis of gallbladder cancer is mainly made by two major sources: 1. pathological confirmation during or after minimally invasive laparoscopic cholecystectomy, which is also known as “accidental gallbladder cancer”, because of the insidious onset of gallbladder cancer and the difficulty of preoperative detection and diagnosis, as well as the clinical experience of the operator. Some “accidents” may not be “accidents” to other experienced surgeons, especially for patients with high suspicion of elevated tumor markers on imaging, so laparoscopic cholecystectomy should not be performed. Since gallbladder cancer is highly metastatic, often combined with nerve invasion, lymph node metastasis and liver metastasis, and laparoscopic surgery requires the establishment of a pneumoperitoneum, lymph node dissection and dissection of the cystic duct or bile duct, if the cut edge is positive, it is theoretically very vulnerable to tumor dissemination and abdominal implantation. At present, there is a great controversy on whether laparoscopic surgery can be performed for biliary tract tumors internationally. My opinion is that laparoscopic or robotic radical surgery for gallbladder cancer is not advisable without ensuring the safety of all. I have a point of view: for tumor patients, we should not stick to the speed of postoperative recovery and the aesthetics of the abdominal wall incision, but should conduct scientific and objective analysis and research in terms of postoperative tumor-free survival and long-term survival time. Back to the topic, if laparoscopic cholecystectomy (LC) is confirmed to be gallbladder cancer, according to the depth of gallbladder cancer infiltration in the gallbladder wall, it is recommended to perform open radical cholecystectomy if the operating hospital has the corresponding technical reserve, or refer to a specialized center for hepatobiliary surgery if it does not. Cholecystectomy alone is sufficient. If the diagnosis is confirmed by postoperative pathology (mostly reported by the patient after discharge), it is recommended to go to a specialized hepatobiliary center for radical surgery of gallbladder cancer as soon as possible. In this case, the condition is relatively early and the prognosis is relatively good. 2. If symptoms appear or physical examination reveals gallbladder occupancy, but subclinical gallbladder occupancy is found on physical examination, and tumor markers (CEA, CA19-9) are significantly elevated, the liver (or upper abdomen) should be further examined by enhanced CT scan to further clarify the local progress of the disease, whether there are metastases to the liver and lymph nodes, whether there is vascular invasion, bile duct invasion, and if the conditions for surgery are available, surgery should be performed as soon as possible. If the conditions for surgery are available, surgery should be performed as soon as possible. If clinical symptoms such as abdominal pain, abdominal distension or poor appetite have already appeared, especially yellow staining of the skin and sclera, which mostly indicates a poor prognosis, a detailed preoperative assessment of the local and systemic conditions should be performed and surgical treatment should be carried out as early as possible. Here we should say a few more words, because gallbladder cancer is too malignant, many patients are evaluated because the tumor progression is too advanced in scope and there is no indication for radical resection surgery what to do? In this case, individualized treatment is needed. If the clinical symptoms are very heavy due to the swelling of gallbladder, abdominal pain and distension are obvious, and the quality of life is extremely low, palliative resection of tumor can be performed, and postoperative specimens can be used for genetic testing to screen targeted therapeutic drugs and whether immunotherapy can be performed. Postoperative adjuvant therapy Tumor is a systemic disease, and the treatment of tumor should not be confined to one corner, but should focus on the system and the whole. This is especially true for gallbladder cancer, because the malignancy is so high that resection is only the first step, and the follow-up treatment must follow, otherwise the surgery will be in vain. In recent years, biotechnology has progressed rapidly and several new treatments have emerged, bringing new hope to patients. Combined with clinical practice, we recommend tegeo combined with oxaliplatin as the basic chemotherapy regimen, or tegeo alone as oral chemotherapy if radical resection is obtained. The resected gallbladder cancer specimens, including gallbladder cancer, liver metastases and lymph node metastases, can be genetically tested if available to screen sensitive targeted therapeutic drugs, change ordinary chemotherapy to precise targeted chemotherapy, change machine gun shooting to sniper gun shooting cancer cells, and the MSI and TMB data from the test results can also confirm whether immunotherapy (PD-1) is feasible. The above are my personal views combined with clinical practice. Due to the rapid development of medicine and biotechnology, some views need to be updated continuously, and I believe that one day, we will cure gallbladder cancer completely.