The first repair is often the best chance for durable biliary reconstruction. ### Core principles: - Control sepsis. - Drain bile collections. - Define anatomy. - Avoid repeated blind attempts at repair. - Refer early for complex injury. - Reconstruct with Roux-en-Y hepaticojejunostomy when appropriate. ### Biliary reconstruction - [[Biliary reconstruction]] - [[Hepaticojejunostomy]] - [[Postoperative bile leak]]