When it comes to gallbladder stones, we are not unfamiliar with it, but when it comes to gallbladder cancer, not everyone knows about it. It is true that gallbladder is less likely to develop cancer than other abdominal organs, so people are not familiar with it, but in fact, with the increasing incidence of gallbladder stones, the incidence of gallbladder cancer is also gradually increasing. Gallbladder stones are a common surgical disease with a high incidence in the population, 12% in Europe, 13.3%-17.9% in the United States, and 5.6% in China. In Wuxi, the incidence rate is probably higher than the domestic average. Every year, nearly 3000 gallbladder resections are performed in Wuxi hospitals, and the number of gallbladder resections in municipal hospitals has exceeded the number of appendicitis surgeries, which explains the high incidence of gallbladder stones. According to the current research report, 70% of gallbladder cancer patients are related to the existence of gallstones, and the time between gallbladder stones and gallbladder cancer can be as long as 10-15 years; gallbladder cancer combined with gallbladder stones is 13.7 times longer than that without stones, and the incidence of stones of 3 cm in diameter is 10 times longer than that of 1 cm. It shows that the occurrence of gallbladder cancer is the result of a combination of factors such as long-term physical stimulation of gallbladder stones, chronic inflammation of mucous membrane, products of infected bacteria and carcinogenic substances. Gallbladder cancer is one of the malignant tumors with poor treatment effect, so prevention is the most crucial. Cholecystectomy is the most effective and the only preventive measure. So, when is gallbladder removal necessary? Generally speaking, it is the four types of patients who have frequent attacks of cholecystitis, stones larger than 2.5 cm, significant or irregular thickening of the gallbladder wall, and gallbladder full of stones. Cholecystectomy in the absence of acute inflammation is a relatively easy procedure to complete, and most of them can be done with laparoscopic techniques with less pain and faster recovery. Postoperative analgesic pumps can also be used to reduce the pain associated with the surgery. Therefore, you do not need to worry about the pain caused by the surgery. It is worth noting that although the incidence of gallbladder cancer caused by gallbladder stones is very low, once it occurs, the overall efficacy of surgical treatment for gallbladder cancer is very poor, so prevention is especially important, and we should operate when it is time to operate, so as not to leave lifelong regrets. Therefore, in order to achieve pre-emptive prevention, it is advocated that active measures should be taken to perform preventive cholecystectomy for high-risk groups. The indications for surgery are as follows: 1. Patients with cholecystitis or cholelithiasis aged 55 years or older, with a disease duration of more than 5 years; 2. Patients with a disease duration of more than 10 years, with a stone diameter of >2 cm or an embedded stone in the gallbladder neck; 3. Patients with significant changes in the nature and rhythm of abdominal pain; 4. Patients with gallbladder polyp-like changes, with a diameter of >1 cm and a wide base or a thicker tip; 5. Patients with significant thickening, limited thickening, irregular thickening of the gallbladder wall as suggested by ultrasound or gallbladder atrophy; 6. CT examination of the gallbladder wall with limited irregular or diffuse thickening, convex and concave luminal wall, and obvious strengthening of the gallbladder wall on enhancement scan; 7. porcelain gallbladder; 8. previous cholecystostomy; 9. congenital confluence abnormalities of the pancreaticobiliary duct. High-risk patients who failed to undergo surgery should be followed up and dynamically monitored regularly to facilitate early detection and treatment of gallbladder cancer. Risk factors are those that can increase someone’s chance of developing a certain disease (such as cancer). Different kinds of cancer have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lungs, mouth, throat, colon, bladder, kidneys, and several other organs. However, having a risk factor or even several risk factors at the same time does not mean that the person will develop the disease. There are also people who have the disease without any of the known risk factors. Scientists have identified several risk factors that can develop into gallbladder cancer. Many are associated with chronic infections of the gallbladder. Gallstones: Gallstones are the most common risk factor for gallbladder cancer. Gallstones are hard, rock-like substances made up of cholesterol and other substances. About 75 to 90 percent of patients have gallstones and chronic inflammation of the gallbladder at the time of diagnosis of gallbladder cancer. But while gallstones are very common, gallbladder cancer is very rare, especially in the United States. Most patients with gallstones never develop gallbladder cancer. Porcelain gallbladder: Porcelain gallbladder is a condition in which the wall of the gallbladder is covered by calcium deposits, sometimes after severe inflammation of the gallbladder. Patients with this condition have a high risk of developing gallbladder cancer, but recent studies have also questioned this risk. Doctors may recommend surgery to remove the porcelain-like gallbladder. Bile duct cysts: The bile duct is the organ that processes bile and transports it from the liver and gallbladder to the small intestine. The bile ducts in gallbladder cysts hold approximately 1.136 to 2.272 liters of bile. The cell lines of the cysts usually have precancerous lesions, which increases the patient’s risk of developing gallbladder cancer. Gallbladder polyps: Gallbladder polyps are swollen growths in the lining of the gallbladder. Some gallbladder polyps are formed by small gallstones embedded in the gallbladder wall, or they can consist of small tumors or inflammatory conditions. Polyps larger than 1 cm are likely to be malignant, so doctors usually recommend removing the patient’s gallbladder if they are large. Typhoid fever: Patients who are chronically infected with Salmonella or who carry the disease are six times more likely to develop gallbladder cancer than patients who are not infected. Typhoid fever is rare in the United States, with fewer than 600 cases per year. Chemicals in industry or the surrounding environment: Animal studies have shown that a nitrosamine chemical can cause gallbladder cancer. People working in rubber plantations and metal industries are more likely to develop the disease than people in ordinary environments. Abnormalities in the hepatopancreatic jugular or bile ducts: The hepatopancreatic jugular is the area that connects the bile ducts (which carry bile from the liver and gallbladder) to the pancreatic ducts (which carry digestive juices from the pancreas). The abnormality here is a malfunction in their connection. Patients with this abnormality usually have a high risk of gallbladder cancer and often acidic digestive juices flow back into the ducts. This reflux also prevents the normal excretion of bile. Scientists are unsure whether it is pancreatic fluid or concentrated bile that increases the chance of gallbladder cancer. Age: Most patients who develop gallbladder cancer are around 70 years old. Family history: Gallbladder cancer can run in families. Family history can increase the chance of gallbladder cancer, but the risk is still very low because the disease is rare. Gender: In the United States, the prevalence of gallbladder cancer is about twice as high in women as in men. Two important risk factors, gallstones and cholecystitis, are more common in women than in men. Obesity: Patients with gallbladder cancer usually have increased weight or are obese compared to the normal population. Race: Native Americans, especially those of southwestern U.S. and Mexican-American descent, have higher rates of gallbladder cancer. They are more likely to develop gallbladder cancer than people of other races.