Biliary complications are some of the most critical problems in liver transplantation. In this study, we retrospective analyzed the early results of intraoperative transhepatic biliary catheter insertion technique for biliary reconstruction at our hospital. Since November 2004, we used this technique in 66 patients (32 children, 34 adults). In the new technique, a 5-F Kumpe catheter is inserted into the biliary system in 2 steps. One step is completed at the back table, and the second step is completed during the recipient operation. Fifteen patients received whole-liver grafts, 23 received a right lobe and 30 received a left-lateral lobe or left lobe. The mean graft-weight–to–body-weight ratio in the livingdonor liver transplantations was 1.6%±1.0% (range, 0.8% to 4.1%). Intraoperative transhepatic biliary catheter insertion was performed with a duct-to-duct anastomosis in 60 patients and with a Roux-en-Y hepaticojejunostomy in 6. Five biliary complications occurred in 4 patients, two of which had bile leakages from the anastomotic site during the early postoperative period. Biliary stenoses developed from the anastomotic site in 2 patients and from the nonanastomotic site in 1 patient in the late postoperative period. In conclusion, this new technique of biliary reconstruction— with intraoperative biliary catheter insertion—has significantly reduced our biliary complication rate. Transhepatic biliary stenting prevents biliary complications and makes it simple to maintain percutaneous access in the event that such problems arise. Intraoperative transhepatic biliary catheter insertion at the back table helps providing good biliary drainage after liver transplantation.