Objective: To compare the effects exerted by endoscopic gallbladder-preserving cholecystolithotomy (EGPCL) with those by cholecystectomy on the postoperative defecation function in patients with gallstones. Methods: Questionnaire follow-up investigation was conducted in 330 patients (more than one year after operation), who were selected, by stratified random sampling, from the gallstone patients treated between 2001 and 2011 in our hospital. The incidences of postoperative diarrhea and constipation of the patients were analyzed. Results: In total, 298 valid questionnaires were returned. Of the patients, 28 cases underwent laparoscopic cholecystectomy (LC), 108 cases underwent open cholecystectomy (OC) and 162 cases underwent EGPCL. In LC, OC and EGPCL group, the incidence of postoperative diarrhea was 3.57% (1/28), 6.48% (7/108) and 0.62% (1/162), incidence of postoperative constipation was 10.71% (3/28), 9.26% (10/108) and 2.47% (4/162), and incidence of alternating diarrhea and constipation was 35.18% (38/108), 21.43% (6/28) and 16.67% (27/162), respectively. The incidences of above three conditions in EGPCL group were all significantly lower than those in cholecystectomy (LC+OC) group (all P<0.01). Both diarrhea and constipation were not associated with the age of the patients undergoing either cholecystectomy or EGPCL (all P>0.05). Conclusion: Gallbladder removal may cause diarrhea and/or constipation. Gallbladder function preservation-oriented operation is recommended for those with preoperative abnormal defecation dynamics.