Asymptomatic intrahepatic bile duct stones do not require treatment; regular follow-up examinations are recommended. Surgical treatment should be considered for those with recurring clinical symptoms. The principle of surgical treatment is to remove the stones as much as possible, identify and address bile duct strictures and obstructions, remove infected areas and the sites of stones to restore and establish unobstructed bile drainage, and prevent recurrence of the stones. Surgical methods include choledochotomy for stone removal, bilioenteric anastomosis, and hepatectomy.