目的:探讨肝脏移植胆道重建的外科技巧和影响胆道重建效果的因素。方法:对中山大学附属第一医院器官移植中心2004-2005年施行368例同种原位肝移植病人的临床资料进行分析总结。结果:368例肝移植病人中36例（9.8％）发生与胆道相关的并发症。23例经非手术治疗而愈；13例行开腹手术治疗，其中7例接受再次肝脏移植。5例因胆道并发症导致死亡，死亡原因为严重胆道感染和腹腔感染，病死率为13.9%。结论:保证供、受体胆管断端良好血液供应，正确选择胆道重建方式，精细的显微外科胆管吻合技术和确保胆管通畅性等，是提高胆道重建质量、降低胆道并发症发生率的重要因素。

Objective:To approach the surgical technique in biliary reconstruction and the affecting factors of its quality. Methods:Three hundreds and sixtyeight cases of the clinical data of allograft orthotopic liver transplantation in the First Affiliated Hospital of Sun Yatsen University from 2004 to 2005 were analyzed retrospectively. Results:Of the 368 cases,36 cases (9.8%) encountered the biliary tract associated complications.Twentythree cases were cured by nonsurgical therapies.Thirteen cases needed abdominal surgical intervention with 7 cases receiving retransplantation.And 5 cases died of biliary complications,accounting for 13.9% death in the series.The causes of death were severe biliary infection and abdominal infection. Conclusion:Adequate blood supply for both donor and recipient biliary endings,correct choices of methods for biliary reconstruction,subtile microsurgical anatomosis technique to ensure the patency of biliary tract are important for elevated quality of biliary reconstruction and decreased biliary complications.