The right and wrong of biliary lithotripsy is a matter of wisdom and mercy. In my humble opinion, biliary lithotripsy provides the lowest risk treatment option for high-risk patients with acute cholecystitis, but for general patients it only caters to the patients’ desire not to have their gallbladders removed, the medical background is not adequate, the efficacy is not certain, and it is not recognized by the peers. Imagine why such a simple procedure is not promoted and why it is not carried out in large domestic hospitals? Why is it not carried out in foreign hospitals? Why is the name of this procedure not included in hospital charges? The key is that the problem of how to prevent the recurrence of stones after bile preservation has not been solved, which means that it is not only difficult to avoid the recurrence of stones in the future, but also may bring trouble for future surgical treatment, and the gallbladder will be removed after all. This approach only treats the result, preserving the cause of the disease and the site of stone production. Another issue that must be considered is that treatment that preserves the gallbladder does not reduce the risk of gallbladder cancer. Given the higher rate of stone recurrence in the study data, laparoscopic cholecystectomy is recognized as a more effective treatment.