Do you have to remove the gallbladder for gallstone surgery?

In clinical practice, if gallstones produce obvious clinical symptoms, such as pain in the right upper abdomen, subxiphoid pain, fever, accompanied by vomiting, abdominal distension, etc., patients are generally recommended to undergo surgical treatment. 1. Direct gallbladder removal: The gallbladder and the stones inside the gallbladder are treated radically. In this case, the lesions can be effectively removed and recurrence is not easy. However, a small number of patients may suffer from indigestion, diarrhea, or a combination of sequelae such as bile reflux gastritis after surgery. In this case, dietary control or cholestatic medication can be used to effectively improve the situation. 2. Biliary stone retrieval: the gallbladder is preserved and the stones are removed. If there is inflammatory thickening of the gallbladder itself before surgery, the gallbladder infection may recur after surgery and affect normal work and life. In addition, the probability of stone recurrence is relatively high after gallbladder preservation, even with active dietary regulation and long-term medication, the probability of stone recurrence can still reach 10%-20%, which may lead to the need for surgery again at a later stage; 3. Partial gallbladder removal: mainly for patients whose stones are confined to the bottom of the gallbladder. The gallbladder is gourd-shaped, and sometimes due to the narrowing of the middle part of the gallbladder, it is separated from the front half of the gallbladder, and the inflammation of the gallbladder and the stones are stored at the bottom of the gallbladder. Therefore, most of the gallbladder stone surgery should be done to remove the gallbladder, but not all of them must be done. Before the surgery, we should clarify the indications for the surgery, and if the conditions allow, the patient can consider gallbladder preservation and stone extraction.