Patient: Recent physical examination revealed gallbladder stones with no sensation and no obvious symptoms. The physical examination report described roughly as follows: gallbladder of normal size and morphology, wall thickness of 4 mm, less than smooth, two strong light clusters of 13 mm and 14 mm visible, followed by acoustic shadow, moving with body position. There was also a mild fatty liver. I had undergone a gastrectomy 20 years ago. Last summer, I had a few epigastric distensions and pains and thought they were stomach pains, but a gastroscopy did not reveal any abnormalities and I was fine after taking some stomach medicine. Recently, I have noticed yellow urine and small red bumps and occasional boils on my skin. In addition, there is no other pain or discomfort. Is surgery necessary? Is there any better treatment for lithotripsy or even stone removal? Thank you! Liu Shengli, Department of General Surgery, Zhongda Hospital, Southeast University: The tendency to develop gallbladder stones after gastrectomy is related to the lack of gallbladder power during the surgery. It is generally difficult to avoid cutting off the vagus nerve that innervates the gallbladder during gastric surgery, so gallbladder emptying is impaired and bile cannot be replaced in time, thus forming stones. Once there are stones in the gallbladder, it is advisable to actively treat them surgically. Treatment with laparoscopy is less invasive and is estimated to be less difficult for you.