肝内胆管结石作为我国肝胆外科领域的高发疾病，其临床治疗面临多重挑战。传统解剖性肝切除术式难以实际实施以及胆管狭窄矫正效果受限是结石易残留与复发的核心机制。针对这一临床难题，胆道外科已逐渐发展出以肝静脉三维走行特征联合病理性胆管树分布模式为导向的肝内胆管结石病的精准、微创切除理念。在技术实施层面，需建立规范化操作体系，包括腹腔镜下精准肝实质离断、肝门部胆管成形重建，同时结合术中超声、吲哚菁绿(ICG)荧光染色标记、多镜联合取石等辅助技术。

Intrahepatic bile duct stones, as a prevalent disease in the field of hepatobiliary surgery in China, present multiple challenges in clinical management. The core factors contributing to stone retention and recurrence lie in the practical difficulties of implementing traditional anatomic hepatectomy and the limited efficacy in correcting biliary strictures. In response to this clinical dilemma, the specialty of biliary surgery has progressively developed a precise and minimally invasive resection concept guided by three-dimensional hepatic venous anatomy combined with lesioned bile duct tree distribution patterns. At the technical implementation level, it is imperative to establish a standardized operative system encompassing laparoscopic precision parenchymal transection, hilar bile duct plastic reconstruction, along with auxiliary techniques such as intraoperative ultrasound, indocyanine green fluorescence staining guidance, and multi-endoscopic combined stone extraction approaches.