With the widespread clinical use of cholangioscopy, it extends the surgeon’s view into the gallbladder, allowing a full view of the gallbladder cavity and achieving the extent of removing all stones from the gallbladder under the scope, greatly reducing the residual gallbladder stones. Therefore, from the mid-1990s, the call for preserving a functional gallbladder emerged again in China. The simple idea that everyone wants to preserve the gallbladder is unmistakable. However, not everyone’s gallbladder can be preserved. Surgery to preserve the gallbladder is inappropriate for patients with the following conditions 1, the gallbladder in the acute inflammatory stage (including septic, gangrene, perforation, inflammatory package, gallbladder neck or gallbladder duct stone impaction, etc.); 2, gallbladder stones combined with bile duct stones, or mud-like stones; 3, gallbladder atrophy; 4, gallbladder adenomyosis or gallbladder wall thickening, can not exclude gallbladder cancer; 5, the gallbladder has a separation, the gallbladder into two cavities of communication. So which patients with gallbladder stones are suitable for gallbladder preservation? Currently, it is believed that patients with asymptomatic gallbladder stones, or so-called “resting stones”, have the best chance of having their stones removed and retaining their gallbladder. If you fit this profile, does it mean that your gallbladder will be preserved if you have stones? Not yet. There are several conditions that must be met in order to preserve the gallbladder. First, the gallbladder must have good contractile function. Ultrasound after oral cholecystography or lipid meal indicates that the gallbladder is contracted up to 1/3 or more. Second, there must not be a history of open surgery, perforation, or other acute inflammatory conditions in the upper abdomen. At the same time, the gallbladder mucosa is smooth under ultrasound, the gallbladder wall is within 3-4 mm, the stones are single or multiple, the morphology is regular, the intra-biliary sound transmission is good, the gallbladder length diameter is between 5-8 cm, and there can be no separation within the cyst. There is no significant restriction on age in general, but young people are more suitable. If the above conditions are met, and if there is a desire to preserve the gallbladder, only then can the gallbladder preservation surgery be considered. There are several other points that need to be clarified regarding gallbladder preservation surgery: First, the purpose of gallbladder preservation surgery is to preserve the functional gallbladder and to try to remove stones from the gallbladder. However, because the cause of the stones is not fundamentally controlled, the stones can still recur. Therefore, it is controversial in medical science at present. Therefore, only for cases selected strictly according to the indications is it recommended to try gallbladder-preserving surgery. Secondly, preoperative tests can only initially determine that the gallbladder can be preserved, which is not the same as successful gallbladder preservation. Therefore, one must be prepared for open or laparoscopic removal of the gallbladder. Thirdly, patients should be closely followed up after biliary surgery to know whether there is any recurrence of stones. Ultrasound examination is recommended in March, June and one year after surgery. Thereafter, annual follow-up should be performed, and the patient should also be seen at any time if symptoms of gallbladder stones appear.