Hepatolithiasis is a type of lithiasis that occurs above the confluence of the left and right hepatic ducts. This condition can cause bile duct obstruction and stasis, increasing the likelihood of stone formation. Mechanical obstruction and recurrent inflammatory stimuli can exacerbate bile duct blockage, leading to severe complications such as cholangitis, liver atrophy, cirrhosis, and even the development of cholangiocarcinoma. Intrahepatic cholangiocarcinoma (ICC) is a common malignant liver tumor originating from the intrahepatic bile duct epithelium. It is characterized by high malignancy, low surgical cure rate, high postoperative recurrence rate, and poor prognosis, making it a significant public health concern. The etiology of ICC is still unclear, but numerous studies have indicated that hepatolithiasis is one of the high-risk factors for ICC. Prolonged mechanical and chronic inflammatory stimuli from stones can lead to the development of the bile duct epithelium along the direction of hyperplasia, atypical hyperplasia, and precancerous lesions, eventually evolving into ICC. Based on the degree of association between pathogenic factors and hepatolithiasis, ICC can be classified into hepatolithiasis-related intrahepatic cholangiocarcinoma (HICC) and non-hepatolithiasis-related intrahepatic cholangiocarcinoma (NHICC). Surgical intervention remains the primary treatment for ICC, and early radical hepatectomy can effectively improve the overall survival rate and prognosis of ICC patients. As an area with a high incidence of hepatolithiasis, the incidence of HICC in our country has also been increasing in recent years. Therefore, comprehensive management of HICC is of significant clinical importance. Given the above background, this article focuses on HICC and summarizes the differences in perioperative management between HICC and NHICC. The aim is to provide individualized and precise perioperative management for HICC patients throughout the hepatectomy period to improve the diagnostic rate, provide accurate treatment, accelerate recovery, and enhance the prognosis.