The treatment of cholelithiasis is not a “one-size-fits-all” treatment. It is now a popular international practice to use different treatment measures according to the patient’s specific situation, i.e. individualized treatment, and to “tailor” a set of treatment plans for the patient. 1. How to treat patients with cholelithiasis who are usually asymptomatic? Generally speaking, patients with asymptomatic or mildly symptomatic gallbladder stones do not require routine prophylactic cholecystectomy. In other words, although the physical examination reveals that the patient has gallbladder stones, but usually there is no right upper abdominal pain, nausea and other symptoms, it can be treated without surgery, take some biliary tablets to prevent the onset of disease, and pay attention to follow-up ultrasound every three months or six months. 2.How to treat patients whose gallbladder stone symptoms obviously affect their work and life, or who have had previous episodes of biliary colic, acute cholecystitis, or biliary pancreatitis, etc.? In this case, we recommend that surgery should be performed to remove the gallbladder. In this case, conservative treatment can only temporarily relieve the symptoms, which not only cannot effectively cure the lesion, but also will delay the opportunity of surgical treatment and cause more serious complications, which is obviously not conducive to the patient’s recovery. 3, bile cutting or bile preservation? Many young patients have this question. They know that their condition already requires timely surgical treatment, but considering that they are still young, they cannot help but be concerned that their lives will be affected after gallbladder removal. Therefore, these patients often turn to the next best thing and ask their doctors to preserve their gallstones. Cholecystectomy is a minimally invasive procedure in which the gallbladder is pulled out through a small incision in the abdominal wall under laparoscopic guidance. Then, the surgeon will cut open the bottom of the gallbladder and use a choledochoscope to clear the gallbladder of stones or remove polyps, and then close the gallbladder to “keep” a functioning gallbladder. This procedure is one of the emergency management measures for acute calculous cholecystitis and can be used in patients whose gallbladder is found to be unresectable or difficult to remove intraoperatively. However, the current findings do not confirm the long-term efficacy of biliary stone extraction over cholecystectomy, and there is a risk of recurrence after surgery. Therefore, we recommend that cholecystectomy is the best option for patients with symptoms and previous episodes of biliary colic, acute cholecystitis, or biliary pancreatitis. This is the most definitive method to treat benign gallbladder diseases. 4.Open or minimally invasive? Minimally invasive treatment, as a more humane and reasonable treatment, has become a popular trend in the field of surgery in recent years. The Hepatobiliary and Pancreatic Center of Shanghai First People’s Hospital South is a surgical team featuring minimally invasive treatment of hepatobiliary and pancreatic diseases and is capable of performing a series of minimally invasive treatments in this area. The advanced double-scope combined operating room of the South Gastroenterology Center has also been accepted and can provide one-stop systematic gallstone treatment solutions for patients using advanced “double-scope combined” or “triple-scope combined” techniques.