Cholecystitis and gallbladder stones are common and prevalent in the elderly. Due to the prevalence of varying degrees of organ decompensation in elderly patients, the relative surgical risk is high and the complication rate is also higher; therefore, preoperative evaluation is very important. Chest X-ray, electrocardiogram, echocardiogram and pulmonary function measurement should be routinely performed, reasonable treatment for comorbidities should be provided to reach or approach normal levels, and intraoperative attention should be paid to monitoring changes in comorbidities and timely management. Patients with hypertension should take oral antihypertensive drugs to keep blood pressure under control at 140 to 150 /90 to 95 mmHg before scheduling surgery to prevent complications of cerebrovascular accidents. Patients with cardiac disease should undergo aggressive preoperative treatment. Patients taking aspirin should stop taking it for 3 days before surgery, and patients with combined diabetes should apply insulin to control blood glucose 7.3 to 8.3 mmol/L, which is safer at this time. For patients with chronic bronchitis and emphysema, laparoscopic cholecystectomy (LC) can be performed only after the condition is stabilized by measuring pulmonary function, resolving sputum and relieving cough, and controlling infection with antibiotics before surgery.