With my continuous efforts, I have performed “bile-sparing surgery” for many patients with gallbladder lesions, allowing them to retain a functional gallbladder while removing gallbladder lesions. Many patients have been calling and consulting with the department, and there are many things they do not understand, so I will briefly explain them as follows. Why bile-sparing surgery? What is the current status of biliary surgery? Which patients are suitable for biliary surgery? Which way is better for biliary surgery? First, the history of cholecystectomy In 1867, Dr. Bobbos in the removal of abdominal tumors, the gallbladder by chance to cut open the removal of stones. 80% of the stones “high recurrence rate”, so that it is out of business. Until 1882, Dr. langenbuch completed the first cholecystectomy, gallstones surgical treatment into the period of bile cutting. And put forward the hotbed theory: not only because the gallbladder contains stones, but also because it can grow stones” assertion. Arguments against the “hotbed theory”. The “hotbed theory”: The Small’s triangle metabolic theory, which states that the gallbladder is oversaturated with cholesterol and precipitates solid cholesterol crystals to form cholesterol stones. Cholesterol is secreted by the liver, so the “hotbed” for stone formation is not in the gallbladder, but in the liver. According to Prof. Ran Ruitu, gallbladder stones originate from the liver and the indication for cholecystectomy (gallbladder stones) should be revised. Therefore, the modern view is that the hotbed doctrine is outdated today and should not be advocated. II. Adverse effects after cholecystectomy Dyspepsia and reflux gastritis Cholecystectomy leads to bile duct injury Increased incidence of choledochal stones after cholecystectomy Impact of cholecystectomy on the incidence of colorectal cancer: a significant increase in the incidence of colorectal cancer III. Evolution of cholelithotripsy Cholelithotripsy: incision of the gallbladder to remove the stone, but preservation of the gallbladder. Stage I: old-style “biliary lithotripsy”: cut open the gallbladder to remove the stone and then suture the gallbladder. Stage 2: Percutaneous cholecystoscopy “biliary lithotripsy” Stage 3: Extracorporeal (shock wave) lithotripsy: only crushing but not removing stones. Stage 4: New endoscopic minimally invasive biliary lithotripsy In the past, cholecystostomy was used as the main method of biliary preservation, and the adhesion of the fistula fixed the bottom of the gallbladder in the abdominal wall, which affected the contraction of the gallbladder. Submucosal stones in the gallbladder wall have a 5-year recurrence rate of >60%. Nowadays, the endoscopic approach of bile preservation is used to enter the gallbladder to remove stones, which can remove all the submucosal stones in the gallbladder wall and reduce the recurrence of stones. 5-0 absorbable suture, without putting a drainage tube to reduce adhesions and reduce the impact of gallbladder function. 5 years <5%. Fourth, the current status of bile preservation surgery In December 2007 held the first national endoscopic minimally invasive bile preservation academic conference. The 13th National Academic Conference on Biliary Surgery in 2008, Academician Huang Zhiqiang clearly pointed out that: endoscopic biliary lithotripsy (carried out) is a major event in the 21st century, a major event in China! Endoscopic biliary lithotripsy specifications have been collected and compiled into the textbooks of institutions of higher learning - the National Pharmacy Department of Surgery textbook. Domestic some of the more famous hospitals are also gradually carry out this technology V. "Biliary surgery" indications Asymptomatic gallbladder stones. Asymptomatic gallbladder stones, gallbladder polyps without precancerous lesions. Symptomatic gallbladder stones, good gallbladder contraction function, >50%, gallbladder wall <4mm. Patient's age is less than 70 years old. Patient is willing to preserve gallbladder. No history of multiple chronic diseases and abdominal surgery. Cholecystectomy is still the gold standard for gallstones. A portion of gallbladder stones have normal gallbladder function; most gallbladder polyps are benign. Everything is done, not in line with the trend of today's medical development. It is an indisputable fact that the recurrence rate of endoscopic biliary lithotripsy has decreased significantly. Under the premise of strictly mastering the indications and respecting the patients' wishes, in addition to carrying out cholecystectomy, we have also learned the new minimally invasive bile preservation technology, which will make more patients trust and benefit more patients.