Cholecystectomy has become the standard treatment for gallbladder stones and other benign gallbladder diseases because of its efficacy. However, ensuring the effectiveness of surgical treatment, minimizing the trauma and functional loss to patients, and reducing the impact on their postoperative quality of life is the common expectation and pursuits of patients and surgeons. In the 1980s, surgeons at home and abroad used intracystic lithotripsy and indwelling drainage tube to carry out bile-sparing surgery, which has been called the old type of gallbladder-preserving surgery. However, the controversies surrounding it eventually subsided, due to the limitations such as a high postoperative recurrence rate of stones. In 1992, Prof. Zhang Baoshan adopted the choledochoscopy to carry out biliary surgery, giving up the way of intracystic lithotripsy and indwelling drainage tube and focusing on the observation and operation under the direct vision of choledochoscopy, which effectively avoids the residual stones and greatly reduces the recurrence rate of postoperative stones, which is called the new type of gallbladder-preserving surgery. Since the introduction of the new surgical type, it has always been accompanied by controversy, and the focus of the debate is still the recurrence of stones and the gallbladder after biliary lithotripsy as a risk factor for gallbladder cancer has also become the focus of controversy. Arguments and discussion always be the companion of scientific development, which helps to clarify understanding, promote communication and cooperation among scholars with different viewpoints, and promote the progress of science. Reviewing the literature and combining personal experience, the author aims to discuss and analyze the controversies in biliary conservation surgery.