In all pathologies in which resection of the common bile duct or hepatic duct is necessary (e.g., cholangiocarcinomas of the hilum, tumors of the head of the pancreas, tumors of the papilla of Vater), bile flow is restored with a bile duct-jejunal end-to-side anastomosis over a Roux-excluded Y-loop or, more commonly, a hepatic-jejunal anastomosis. In the case of stenosis involving the bifurcation of the hepatic ducts or the right or left hepatic duct, it may be necessary to perform a double hepatic-jejunal anastomosis.