Gallbladder stones are a disease that hepatobiliary surgeons come into contact with almost every day in the outpatient clinic, and whether or not to receive surgical treatment is the most important concern for patients. Here, based on my clinical experience, I briefly state my personal opinion on some common conditions for your reference. The important basis for surgical treatment is made mainly based on both imaging and patient symptoms. Ultrasound of the upper abdomen is the basic examination of gallbladder stones and the preferred means of examination, which requires attention to the following aspects: the size of the gallbladder, especially the thickness of the gallbladder wall, whether it is smooth or not; the site, number and size of stones. Other examination modalities can also be CT, MRI. The main symptoms are vague pain in the upper abdomen or right upper abdomen when over-eating, eating high-fat food, working under stress or poor rest, or discomfort with fullness, which can be easily misdiagnosed as “stomach disease”. It may radiate to the right scapula and back. In the case of asymptomatic gallbladder stones, if the patient is in his twenties or thirties, there is no change in the shape of the gallbladder, no thickening or roughness of the gallbladder wall, observation may be recommended, i.e., ultrasound every six months to a year. If the patient is middle-aged or elderly, with a long history of disease and multiple stones, I personally recommend early elective surgery because there are many cases of acute cholecystitis, embedded stones, and even acute cholangitis and pancreatitis, which can cause more serious diseases and make surgery much more risky and difficult. For patients with filled gallstones or gallbladder atrophy, surgical treatment is recommended, regardless of whether they are symptomatic or not. If the symptoms occur more than 2-3 times a year, or even if the symptoms are mild but they feel that they are affecting their work and life, surgery is recommended. Regarding the surgical procedure: Currently, more than 95% of gallbladder stone patients in large tertiary hospitals undergo laparoscopic cholecystectomy, which is considered minimally invasive surgery. Individual patients may still need to undergo the traditional open cholecystectomy approach. Personally, I am cautiously opposed to the so-called “biliary stone retrieval” approach. Although it involves a complex professional controversy, its validity and reliability have not been confirmed by either the mainstream professional consensus at home or abroad, or by a large amount of clinical rigorous case data. I am also personally opposed to the treatment modality of drug lithotripsy, lithotripsy or lithotripsy. Because the mechanism of gallbladder stone production is different from that of urinary stones, and the fluid dynamics are also very different, these treatments may cause more complicated conditions, such as stone impaction, cholangitis, obstructive jaundice, liver damage, etc. Regarding the physical effects after removal of the gallbladder: the main function of the gallbladder is to concentrate bile, not to produce it, which is produced by the liver, a point that is easily misunderstood in a wide range of patients. A large number of clinical cases have confirmed that there is little damage to patients after gallbladder removal, and almost all patients are able to recover their digestive function within 3-6 months after surgery.