The results showed that 1. although the tumor of the base body was larger, the R0 resection rate was higher than that of the neck cancer, and the median survival period after the expanded clearance was also greater than that of the neck cancer. Meanwhile, it was found that conventional clearance surgery did not allow overall resection of the surrounding organs such as colon, gastric sinus and duodenal bulb in the liver area, nor did it clear No.16 No.8p and No.13 lymph nodes, and its median survival was inferior to that of expanded clearance surgery. The lymph nodes of No.16 No.8p and No.13 should be resected during the expanded clearance, which are deep and difficult to be cleared, and their positive rate was found to be not low, especially in the No.16 group, where most of the distant recurrences are summarized and were not resected in the past. These two factors may contribute to the difference in median survival time between expanded and conventional surgery. Palliative surgery, on the other hand, only temporarily relieves biliary or gastrointestinal obstruction and does not contribute to survival. Gallbladder cancer is not sensitive to radiotherapy, which requires that surgery should be as thorough and clean as possible to ensure better survival time. In the past, the classification of the primary site of gallbladder cancer was not meticulous enough, and the scope of surgical resection was required to be simple and general, which was not highly operable. Our own cases concluded that only hepatoduodenal ligament pulsed treatment was performed in the early stage, and vascular invasion was not treated, which could lead to intrahepatic metastasis at an early stage (3-6 months) after surgery, now we all perform complete meaningful skeletonization without any tissue between vessels, and all invaded vessels are locally resected + reconstructed, and all postoperative survival rates have improved. Therefore, subdividing gallbladder cancer stage Nevin IV into carcinoma of the underlying body and carcinoma of the neck and differentiating surgery for them is of some significance for long-term survival; appropriately expanded surgery in the absence of distant metastases can improve the median survival time of patients.