The best treatment for gallbladder stone patients is cholecystectomy surgery, which is easy and effective, and is now accepted by the majority of gallbladder stone patients. However, there are very few gallbladder stone patients who still have stomach pain after cholecystectomy, which makes the patients feel very confused and feel that the doctor did not do a good job and brought them pain. In fact, there are many reasons for stomach pain after gallbladder surgery, some of them are caused by doctors’ carelessness, but there are also many other reasons, in general, the causes of stomach pain after gallbladder removal surgery may be the following. I. Causes caused by the bile duct itself Some patients with gallbladder stones have preoperative combined lesions such as small stones in the common bile duct, intrahepatic bile duct stones or sphincter of Oddi stenosis, and if the treatment of these lesions is omitted when doing cholecystectomy, stomach pain may occur after surgery. 1. Small stones in the common bile duct: It is the most common cause of stomach pain after cholecystectomy. Small stones in the common bile duct can be preoperatively coexisting, intraoperative residual, or postoperative reoccurrence. The preoperative coexistence of small common bile duct stones with gallbladder stones occurs from time to time, and is most often the result of a missed diagnosis because MRCP was not performed during the preoperative examination. Residual stones are stones that were not removed during surgery, mostly due to the surgeon’s lack of care or skill in intraoperative exploration or failure to routinely perform choledochoscopy during surgery. However, sometimes intrahepatic bile duct stones are found by the surgeon during intraoperative probing, but they are difficult to remove due to technical difficulties, or the patient’s critical condition does not allow long and careful probing and stone removal. Recurrent stones are stones that have been removed at the time of surgery and occur again later. However, it is sometimes difficult to determine whether a common bile duct stone is a residual stone or a recurrent stone. However, they are all treated in the same way. 2.Stenosis after bile duct injury: more than 95% occur after cholecystectomy, and the incidence is usually around 0.1% to 0.2%. After bile duct injury, bile extravasation, biliary peritonitis, fibrotic stenosis, poor bile drainage, recurrent biliary ductitis, and patients often have stomach pain, fever or yellowing of the whites of the eyes. This is one of the serious complications after gallbladder surgery and often needs to be handled by surgery again. 3, the gallbladder duct remains too long: the gallbladder duct remains more than 1cm after cholecystectomy is residual too long. It is often caused by inexperience of surgeon, surgery during acute inflammation of gallbladder, anatomical abnormality or serious adhesions of gallbladder neck which are not easy to separate. It usually does not cause symptoms, but if there are stones in the gallbladder duct, or when the lower end of the bile duct is obstructed, poor bile drainage, increased pressure in the lumen, dilatation of the residual cystic duct and secondary infection, a small gallbladder with inflammation can be formed. In this case, there may be stomach pain, fever, and in some cases, yellowing of the whites of the eyes. There may also be indigestion, anorexia, bloating, nausea, vomiting, etc. Theoretically, the shorter the residual cystic duct, the better, but it is generally believed that it is more reasonable to cut and ligate the cystic duct at 0.3cm to 0.5cm from the common bile duct, which will not damage the common bile duct and can avoid leaving too long. 4.Biliary dysfunction after gallbladder surgery: it is common in young women and can be triggered by mental factors or endocrine dysfunction. It manifests as paroxysmal right upper abdominal pain with abdominal distension, excessive sweating and rapid heartbeat. However, there are no abnormal findings on ultrasound and other imaging examinations. It is thought that the biliary pressure loses its cushioning effect after cholecystectomy and is directly affected by the sphincter muscle. When the sphincter muscle contracts, the patient’s bile duct pressure can increase significantly to appear stomach pain. Many symptoms caused by diseases outside the biliary tract are similar to those of gallbladder stones, and when these diseases are combined with gallbladder stones, they can be mistakenly thought to be caused by gallbladder stones. Some patients have symptoms that existed before the cholecystectomy, but were masked by gallbladder stones. When the patient has had a cholecystectomy the stomach pain appears again. There are many reasons for these, such as gallbladder stone patients with heart disease, pleurisy, esophageal hiatal hernia, ulcer disease, chronic gastritis, chronic pancreatitis, chronic hepatitis, etc. There are also a few patients with duodenal parapapapillary diverticulitis, and more seriously, some gallbladder stone patients have combined gastrointestinal tumors, such as colon cancer and other tumors. Once the patient has undergone cholecystectomy, the symptoms of gallbladder stones disappear, but the symptoms of these combined diseases show up.