Whether chronic gastritis requires surgery also depends on the condition of the disease. If the symptoms are not particularly obvious—such as nausea, vomiting, or acid reflux—and the gastroscopic examination shows atypical symptoms, treatment through medication or dietary adjustments can be considered instead of surgery. However, if there is significant atypical hyperplasia or intestinal metaplasia found during the gastroscopy, suggesting potential malignancy, these conditions may require surgical treatment under gastroscopy.