The formation of gallbladder stones is the result of a combination of genetic and environmental effects. The process can be broadly divided into the following successive phases: Phase I – genetic phase, i.e. congenital abnormalities in hepatic bile acid, cholesterol or lipid metabolism. Phase II – the chemical phase, in which lithogenic cholesterol supersaturated bile appears. Phase III – physical phase, the appearance of light microscopically visible cholesterol crystals involving nucleation in the gallbladder. Phase IV – the anagen phase, in which small crystals grow into stones visible to the naked eye. The fifth stage – clinical symptoms stage, clinical symptoms associated with stones appear, including typical biliary colic symptoms caused by gallbladder jugular or cystic duct obstruction, non-specific symptoms of chronic inflammation of the gallbladder, and symptoms caused by complications of gallbladder stones. Based on this understanding, gallbladder stone prevention can be broadly divided into four levels: primary prevention, to prevent stones from developing in people susceptible to gallbladder stones. Secondary prevention is the effective treatment of asymptomatic gallbladder stones to prevent complications or further increase of stones. Tertiary prevention, treating patients with symptomatic stones to prevent or delay the loss of gallbladder function or prevent complications. Tertiary prevention, after elimination of stones, prevents stone regeneration. Secondary prevention challenges the currently popular view that asymptomatic stones do not require treatment. For a given individual, if it is possible to know if and when symptoms will develop, then they can be left untreated or wait until the problem is imminent. However, this is not the case; we can only detect stones early by screening, but we cannot predict when, where and how they will develop. Before the advent of laparoscopic cholecystectomy, caesarean surgery was, after all, more damaging and intimidating, so most advocated treating it only when symptoms appeared, resulting in patients being admitted to the hospital for surgery only when there were significant clinical symptoms or complications. In addition, this situation often occurs in middle-aged and elderly patients, which naturally increases the risk of surgery and results in relatively high surgical complications and mortality. The advent of the era of minimally invasive surgery, represented by laparoscopic technology, has eased the fear of gallbladder removal and led to an increasing number of patients undergoing gallbladder removal without severe symptoms. On the contrary, encouraged by the advantages of laparoscopic cholecystectomy, a group of “cholecystectomy professionals” have emerged who disregard the function of gallbladder. The best strategy to solve this contradiction is minimally invasive biliary stone extraction. The symptoms and complications of gallbladder stones are caused by the stones and can be achieved by eliminating the stones without removing the gallbladder. Moreover, the gallbladder in the asymptomatic stage functions better, with high preservation value and low surgical difficulty. Therefore, for gallbladder stones, we advocate treating them as early as possible once they are detected and preserving the gallbladder to remove the stones.