To preserve gallbladder or insurance? Opinion 1: The surgical indications for gallbladder removal still need to be strictly controlled. The gallbladder is a non-essential organ for life, but we cannot deny that it has a function. The functions of the gallbladder are as follows: (1) storage of bile: bile is stored in the gallbladder and then discharged from the gallbladder when needed for digestion, so the gallbladder is called the “bile warehouse”. It also plays the role of buffering the pressure of the bile duct. (2) Concentrated bile: Most of the water and electrolytes in the golden-yellow alkaline liver bile are absorbed by the mucous membrane of the gallbladder and returned to the blood, leaving the active ingredients in the bile stored in the gallbladder, which turns into brownish yellow or dark green weakly acidic gallbladder bile. (3) Secretion of mucus: It can secrete 20ml of thick mucus every day to protect the bile duct mucosa from erosion and dissolution of concentrated bile. (4) Emptying: 3 to 5 min after eating, the duodenal mucosa produces cholecystokinin, which causes the gallbladder to contract and discharges bile from the gallbladder into the duodenum immediately to help digestion and absorption of fat, and at the same time as discharging bile, it also discharges bacteria from the bile duct together with bile. Opinion 2: Biliary surgery is not recommended because of its high risk. The main risks of biliary surgery are: (1) recurrence or reoccurrence of the original disease (stones or polyps), which makes secondary surgery inevitable; (2) the difficulty of secondary surgery, which reduces the proportion of minimally invasive surgery and increases the chance of side injuries; (3) misdiagnosis and omission of gallbladder cancer, especially occult gallbladder cancer; PS: the prognosis of gallbladder cancer is extremely poor, with an overall median survival of 3 months and a 5-year survival rate of less than 5%. Viewpoint 3: From the current level of knowledge, the impact of gallbladder removal is not significant. Gallbladder removal will inevitably affect the patient’s digestive function, especially fatty foods, and most patients will lose weight for a short period of time, and will generally adapt to it basically in about six months. A few years ago, some scholars pointed out that gallbladder removal would change the normal biliary and intestinal circulation and possibly increase the incidence of colorectal cancer, but the final results of the big data have not been confirmed, so such a view has been removed from the original textbook. Viewpoint 4: To quote an inappropriate but very graphic analogy: “A gallbladder with stones is like a bun with maggots, if you take out the maggots, can you still have the bun?” The majority of people think they can eat it, but the majority of people think they can’t. This is the current status of the public’s perception of gallbladder preservation. Therefore, it is recommended that patients with gallbladder disorders should go to a regular hospital in a timely manner, and if surgery is indicated, it is not recommended that you choose gallbladder preservation surgery for insurance purposes!