Intrahepatic bile duct stones are hepatobiliary stones above the bifurcation site of the hepatic duct, which have a high incidence and are prone to stone residual and recurrence, and are the focus and difficulty of surgical treatment. Lobectomy or segmental resection is the most effective treatment for intrahepatic bile duct stones. It removes the bile duct with stricture, the liver segment with stones, and removes the good site of bile duct cancer, and has the best long-term effect. Scientific typing of intrahepatic bile duct stones is not only helpful to standardize the diagnosis of intrahepatic bile duct stones, but also can suggest relatively scientific treatment methods and estimate the difficulty of surgery. In order to better standardize and guide the clinical treatment of intrahepatic bile duct stones, the Biliary Surgery Group of the Chinese Society of Surgery has proposed the “Clinicopathological Classification of Intrahepatic Bile Duct Stones” scheme. The clinical treatment guidelines are based on these three types. Type I: the limited type, the stones are confined to one liver segment or subhepatic bile ducts, the affected liver and bile duct lesions are mild, and the clinical manifestations are mostly stationary. Type II: Regional type, the stones are distributed regionally along the intrahepatic biliary tree, filling one or several hepatic segments, often combined with stenosis of the hepatic ducts and atrophy of the affected hepatic segments, the clinical presentation may be obstructive or cholangitis type. Type III: Diffuse type, with stones spread in the bile ducts of both hepatic lobes, and subdivided into three subtypes according to the parenchymal lesions: Type IIIa: Diffuse type without regional destruction, with stones widely distributed in the intrahepatic bile ducts without obvious parenchymal atrophy and fibrosis. Type IIIb: diffuse type with regional destruction, with stones widely distributed in the intrahepatic bile ducts and associated with segmental atrophy and fibrosis of the liver parenchyma, usually combined with severe stenosis of the atrophic liver segment draining the bile ducts. Type IIIc: and diffuse type with biliary hepatic steatosis, stones are widely distributed in the intrahepatic bile ducts and associated with hepatic steatosis and portal hypertension. It is usually accompanied by severe stenosis of the right and left hepatic ducts or bile ducts below the confluence. Type II hepatobiliary stones are clear indications for hepatic resection; whereas clinical management of type IIIa and IIIb intrahepatic bile duct stones requires a highly individualized treatment plan based on a comprehensive analysis of the presence of hepatic parenchymal atrophy, the degree and location of bile duct stenosis, the distribution of stones, and the extrahepatic bile duct situation. Hepatoportal bile duct formation and/or hepatic-intestinal anastomosis is the basic treatment for type III intrahepatic bile duct stones. The need for hepatic segmental resection depends on the presence of disfigured atrophy of the liver parenchyma and the presence of stenoses that are difficult to correct.