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.

Gallstones and acute calculous cholecystitis are common diseases in surgery. China has entered an aging society. Elderly patients are a high incidence group of gallstones and acute calculous cholecystitis. Their surgical diagnosis and treatment strategies need to be formulated individually, and reasonable diagnosis and treatment methods should be comprehensively selected according to the patient′s condition and the medical level of the medical institution. For those who are in good physical condition and can tolerate the operation, it is recommended to give priority to surgical treatment, and the minimally invasive surgery mainly suitable for laparoscopic cholecystectomy (LC) is preferred. Open surgery is more appropriate for complicated conditions or patients whose general conditions are not suitable for laparoscopic surgery. Other minimally invasive treatment measures can be applied at the same time. For patients who can not tolerate surgical treatment, puncture, endoscopy, intervention and other means can be selected, combined with drugs for conservative treatment, so as to obtain the opportunity of surgical treatment or improve the prognosis. In this paper, the latest research literature at home and abroad has been collected to review and summarize the latest research progress in the physiology and aging characteristics of the biliary tract in the elderly, the diagnosis and treatment of gallstones and acute calculous cholecystitis. It is hoped that this paper can provide reference for the clinical diagnosis and treatment of such diseases, and think and prospect the future research.