Lobectomy or segmental resection is the most effective treatment for intrahepatic bile duct stones. It removes the stenosed bile duct, the segment with stones, and the site of bile duct cancer, and has the best long-term effect. The indications for simple lobectomy or segmental resection are: (1) multiple intrahepatic bile duct stones confined to a certain area or segment combined with stenosis or cystic dilatation of the bile duct in that segment, where the stones are difficult to be removed and the stenosis is difficult to be corrected; (2) multiple stones confined to a certain lobe or segment of the terminal bile duct that cannot be removed; (3) fibrosis and atrophy of the liver segment in the combined area; (4) complicated intrahepatic bile duct cancer or suspected cancer. The basic strategy of hepatic resection for intrahepatic bile duct stones is to perform regular hepatic resection according to Couinaud’s functional segmentation.