Skip to main contentLast updated: 07-Nov-2026
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Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Bile Duct & Gastro Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
A hepaticojejunostomy joins the healthy bile duct above an injury to a loop of small bowel. Bile then drains into the gut through the new join.
It is a planned operation, done after infection is under control and the duct has been mapped. It is not an emergency repair in an infected belly.
Blood tests are checked for years afterwards, because the join can narrow late. Early checks make a late narrowing easy to treat.
The types of injury, the tests and the full range of treatment are on our bile duct injury after gallbladder surgery page. This post explains one step in detail: the repair operation.
It is a bile duct bypass. The liver duct is stitched to a loop of small bowel, so bile has a new road into the gut.
The word looks hard, but the idea is simple. “Hepatico” means the bile duct from the liver. “Jejunum” is the first part of the small bowel. “Stomy” means a join.
Normally bile flows down the common bile duct into the bowel. After an injury, that road is cut, closed or scarred. The surgeon builds a new road from healthy duct to healthy bowel.
It is needed when the main bile duct is cut, removed or tightly narrowed, and a stent cannot bridge the gap.
| What was found | Usual treatment |
|---|---|
| Leak from a small side duct | Drain and an ERCP stent; no repair operation |
| Partial tear of the main duct | ERCP stent; repair only if the stent cannot cross |
| Main duct cut or removed | Drain first, then a hepaticojejunostomy |
| Main duct closed by a clip | Drain the liver through the skin, then a planned repair |
| Narrowing that returns after stents | Hepaticojejunostomy |
A stent can heal many leaks, so not every injury leads to this operation. The scans decide, not the first fear. The full ladder of steps is on the bile duct injury page.
Timing matters more than speed. A repair done once infection has settled and the duct is healthy holds up better than a hurried one.
During the wait, a drain through the skin keeps you comfortable. It also keeps the liver working. This waiting time is part of the treatment, not a delay.
The surgeon frees the scarred duct up to healthy tissue, then stitches it to a loop of bowel with fine stitches.
This is a planned, open operation. It is done under general anaesthesia, with an intensive care bed ready. Before surgery, the team studies your MRCP and any drain X-rays, and checks the liver arteries if an artery injury is suspected.
Most people walk the day after surgery and go home in about a week, once eating well and with the drains out.
Pain is controlled with drips and often a thin catheter in the back. Drains are watched for bile or blood. Liver tests are repeated to see the jaundice fall. If a drain through the liver was placed earlier, it may stay for some weeks as a safety line.
Eating restarts in small steps, from sips to a soft diet to normal meals. Most people return to normal food and normal work. The surgeon tells you when to restart heavier effort.
Every operation carries risk, and an inflamed bile duct carries more. The main late risk is that the join narrows again, sometimes years later.
Simple blood tests catch a narrowing early. Liver tests are done every few months at first, then once or twice a year.
An MRCP is added if the tests rise, or if fever or itching returns. You come in the same day for fever with chills, yellow eyes or dark urine.
Choose a surgeon who repairs bile ducts often and works in a hospital with ERCP, radiology and intensive care under one roof.
This is not an operation to learn on. The first repair is the one most likely to last, so the team matters as much as the technique. Ask who will operate, how often they do this repair and who will manage a leak if it happens.
Many patients reach us from another hospital. We work with the first surgeon where we can. The aim is your recovery, not blame. If a stone or another disease is behind the narrowing, read about bile duct stones and cholangitis or benign bile duct strictures.
Call the same day for fever with chills, yellow eyes, dark urine, itching all over, or green fluid in a drain. Do not wait for the next visit.
After a repair, any belly pain that grows instead of easing also needs a check. Always tell a new doctor that you had a bile duct repair.
It is an operation that joins the bile duct from the liver to a loop of small bowel. Bile then flows into the gut through this new join, instead of through the injured duct.
No. Small leaks and some partial tears heal with a drain and an ERCP stent. The repair is kept for a duct that is cut, removed, closed by a clip or narrowed again and again.
After an injury the ends often have a poor blood supply and sit under tension. A direct join tends to narrow later. A join to the bowel avoids both problems.
In an infected belly, stitches hold poorly. Drains, treatment of infection and a scan map of the duct come first. The repair then follows when the tissue is healthy.
Most people walk the next day and go home in about a week, once they are eating well and the drains are out. Your surgeon will tell you what applies to you.
Yes, sometimes months or years later. That is why liver blood tests are checked at set dates. A narrowing found early is usually treated through a tube, and sometimes needs a second repair.
At our centre this repair is a planned open operation, because careful stitching of a scarred duct needs a clear view and good control. The choice is explained to you before consent.
For the full picture of bile duct injury and its care, start at the bile duct injury after gallbladder surgery page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Has someone told you that your bile duct needs a repair operation? Dr Harsh Shah goes through your scans, drain reports and old operation notes with you, and explains the next step in plain words. Bring them to the visit. You can also call, or message us on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
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