First, the early symptoms are extremely atypical, making the diagnosis more difficult. The clinical manifestations of most patients are similar to chronic cholecystitis and cholelithiasis. The main symptom is right upper abdominal pain, radiating to the right scapula, accompanied by loss of appetite, fatigue, abdominal distension, low fever, nausea and jaundice. For female patients over 40 years old with long-term history of chronic cholecystitis and cholelithiasis, if the nature of pain changes from paroxysmal attacks to continuous dull pain in the right upper abdomen with progressive aggravation, local palpable gallbladder mass, progressive jaundice and significant wasting, gallbladder cancer should be considered. In the advanced stage of gallbladder cancer, there may be liver enlargement, ascites, cachexia and other manifestations. Laboratory examination: liver function test can understand the function of liver and identify the nature of jaundice, which is obstructive jaundice. X-ray examination: cholangiogram can show that the mucosa of gallbladder is not bright and the filling defect in the lumen. ERCP finds that the bile duct is suddenly interrupted and the filling defect is eccentric with irregular edge or the bile duct stenosis is long. Other examinations: B-type ultrasound, CT and laparoscopy all have high diagnostic value. Differential diagnosis of gallbladder cancer Patients with gallbladder cancer lack specific clinical manifestations. Most of them are misdiagnosed as cholecystitis and cholelithiasis. Such patients are often in advanced stage when symptoms such as right upper abdominal pain, right upper abdominal mass or anemia appear. In recent years, the improvement of diagnosis mainly relies on the progress of modern imaging and the deepening of the understanding of this disease.