Gallbladder stone (GS) is a common disease. There are no obvious symptoms at early stage for the patient with GS. Obstruction will cause acute cholecystitis. Secondary obstructive cholangitis of GS, biliary pancreatitis, gallbladder cancer due to GS would be serious. Many guidelines and consensuses have been published in the world and from many professional organizations, promoting the normative diagnosis and treatment of GS. However, there are still a lot of controversial issues. Currenly, there is a lack of study on the whole course of GS with large samples. Prevention and early diagnosis with treatment of GS are neglected. It results in insufficient personalized diagnosis and treatment. In order to have the prevention, diagnosis, treatment, prognosis and follow-up which are carried out better, the authors divided the course of GS into four stages according to the pathophysiological characteristics of the occurrence, development and outcome of GS. There are: ①stage of stone forming; ②asymptomatic period without obstruction; ③inflammation and infection stage, inclu-ding obstructive inflammation, pyogenic gangrene, perforation abscess; ④stage of secondary lesions, including abnormal gallbladder morphology and function, GS shift, gallbladder carcinoma. According to the pathophysiological staging, it is beneficial to the personalized diagnosis and treatment based on the standard management for the patients who can benefit more.
