Is gallbladder removal really terrible? Is a gutless hero goodbye to normal life from now on? Does being gutless really increase the incidence of colorectal cancer? Will there be more stones in the common bile duct? These are the most frequently asked questions by patients with gallbladder stones and cholecystitis in the clinic. I think patients who underwent gallbladder removal are best suited to answer this question. Patients after gallbladder surgery in the outpatient clinic always express their gratitude to me, “Thank you, Director Liu, if I had known that I could live a normal life and eat normally after gallbladder removal, I would have had the surgery long ago, all these years of suffering.” Gallbladder stones are one of the most common digestive system diseases. A small number of patients with gallbladder stones will induce biliary colic, followed by bacterial infection, manifesting as acute and chronic cholecystitis, and long-term chronic cholecystitis gallbladder loses its contractile function, which may even develop into gallbladder cancer. The gallbladder is an organ given to human beings by God to store and concentrate bile. But God also gave man the bile duct. Figuratively speaking, the bile duct is the river and the gallbladder is the reservoir on the river. When the reservoir is removed, the river can be widened to compensate for the function of the gallbladder, so that three months after surgery, patients with gallbladder removal can still eat normal food, when bile flows from the widened river. In long-term chronic cholecystitis the gallbladder loses its contractile function and often attacks biliary colic, so the lesser of two evils has to be removed. But actually the quality of life is improved. Media reports always mention that after cholecystectomy, hepatic-intestinal circulation increases and secondary bile acids increase, which increases the incidence of colorectal cancer. The increased hepatic-intestinal circulation is stated as follows: usually most of the bile secreted by the liver is stored in the gallbladder, and after eating foods containing a lot of fats, the gallbladder will contract and discharge the stored bile into the intestine to play the role of helping digestion and absorption. If the gallbladder is removed, the bile secreted by the liver has no place to be stored, so the bile will go directly to the intestine day and night, and the bile will be decomposed by the bacteria in the intestine to produce “secondary bile acids” which are carcinogenic. However, these claims are conjectures in themselves, and there is still no academic debate on the results. A large clinical survey showed that 42,089 gallbladder resection patients with follow-up confirmed that gallbladder removal does not constitute a risk factor for colon cancer. At the same time, if the gallbladder is not removed, patients with chronic cholecystitis and gallbladder stones have no contraction function of the gallbladder itself, and the bile enters the intestine directly, and their state is basically equivalent to that of patients with gallbladder removal, similar to “gallbladder self-excision”. Therefore, there is no big difference in the impact on bile excretion and hepatic and intestinal circulation if the gallbladder is cut or not cut at this time. However, if there are asymptomatic gallbladder stones and the gallbladder has the function of contraction and concentration, it is possible to remove the stones and preserve the gallbladder through biliary stone extraction. Please refer to my other article “Gallbladder stones – do they really need to be removed?” Finally, in patients who have had their gallbladder removed, gallbladder stones tend to be supersaturated with bile, which tends to form stones, and with the loss of the hotbed of the gallbladder, stones may form in the bile ducts. Therefore, it is necessary to review the bile duct ultrasound every six months after surgery. Also the diet should not be too oily. Also patients with resected gallbladder who have family history of colon cancer, colitis and colon polyps should still pay attention to annual review of colonoscopy, after all, these are high risk factors.