The major indications for hepaticojejunostomy are as follows:

The major indications for hepaticojejunostomy are as follows:

• Benign or iatrogenic strictures
• Injuries to the biliary system [7, 8, 9, 10]
Additionally, obstruction from malignancies of the biliary system caused by pancreatic or duct wall tumors may necessitate this operation. Rare indications are trauma and dilated areas occurring in sclerosing cholangitis. In the pediatric population, choledochal cysts are also an indication for reconstruction with hepaticojejunostomy. [11] Because each unsuccessful attempt at repair can cause increased morbidity for the patient, providing long-term functional and anatomic stability is paramount during the reconstruction
Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease and cirrhosis (see “Epidemiology and etiologic associations of hepatocellular carcinoma”). It is typically diagnosed late in its course, and the median survival following diagnosis is approximately 6 to 20 months [1]. Although the mainstay of therapy is surgical resection, the majority of patients are not eligible because of tumor extent or underlying liver dysfunction.
Several other treatment modalities are available, including:
●Liver transplantation
●Radiofrequency ablation (RFA) and microwave ablation
●Percutaneous ethanol or acetic acid ablation
Overall, transplantation remains the best option for patients with HCC. Unfortunately, there is a limited supply of good-quality deceased donor organs. Thus, alternative
treatments, including resection, radiofrequency ablation (RFA), and, potentially, systemic therapy with sorafenib (or, if sorafenib fails, regorafenib), should be used to bridge patients to transplant or to delay recurrence if possible. In patients who experience a recurrence following resection or transplantation, aggressive surgical treatment appears to be associated with the best possible outcome