Benign strictures of the extrahepatic bile ducts and biliary injuries of medical origin are the most common causes of bile duct strictures, and historically the most common procedure used to resolve benign biliary strictures and maintain bile patency has been bile-intestinal anastomosis. However, the classical Roux-en-Y bile-intestinal anastomosis can only play the role of restoring bile drainage and cannot replace the physiological function of the sphincter of Oddi. Although it is now agreed that the bile duct jejunostomy Roux-en-Y anastomosis is a more successful procedure, there is no sphincter function in a small proportion of patients (21%) who still have reflux cholangitis during the long postoperative observation. Although there have been several surgical designs to combat intestinal fluid reflux, there is no surgical alternative to the normal physiological function of the sphincter of Oddi for bile-intestinal anastomosis. In addition, in the late stages of bile-intestinal anastomosis, although the jejunal collaterals are left open for 50-60 cm, some patients still have intestinal fluid reflux and prolonged presence of gas in the bile duct. Under physiological conditions the intestinal flora is continuously multiplying and increasing in number, and the intestine is discharging intestinal contents through normal intestinal peristalsis to maintain the ecological balance of the intestinal flora. When the absentee intestine leaves the main channel of the intestine such as the Y-shaped jejunal collaterals in bile-intestinal anastomosis, the lack of flushing of intestinal contents and the stagnation of intestinal fluid in the intestinal collaterals result in an overproliferation of bacteria in the intestinal lumen and a large increase in the amount of bacteria, and a large increase in the number and species of anaerobic bacteria, which also makes the number of bacteria in the bile tract increase, often resulting in a bacterial count of 108-1011 cfu/ml in the bile, making it easier to develop after bile-intestinal anastomosis biliary tract infection, and more severe clinical symptoms once cholangitis sets in. Preserving the physiological access to the common bile duct and preserving the function of the biliary sphincter is important to obtain good long-term results when managing biliary strictures in the hilar region. High biliary tract injuries or sometimes hilar biliary stenosis due to stones or inflammation form a stenotic ring in the hilar region, while the bile duct below the stenotic ring remains relatively normal, the lower bile duct is patent, and the sphincter of Oddi function is normal. In this case, preservation of the normal physiological regulation of the sphincter of Oddi should be the most desirable, and is also conducive to reconstructive and restorative surgery of the stenosed bile duct. Although a small number of bile duct repairs have been reported over the years, they have not yet been developed into a standardized surgical method. After years of clinical observation, the importance of maintaining normal physiological access to the biliary tract has been better understood. Preserving the physiological access to the common bile duct as much as possible, and standardizing this type of surgery as much as possible, will be beneficial to the preservation of biliary function. The most convenient repair of local bile duct strictures is to use a gallbladder flap, taking care to preserve the vasculature of the gallbladder when separating it, cutting a piece of free gallbladder wall with a vascular tip slightly larger than the bile duct injury, and suturing it over the defect of the bile duct in a simpler way. In the case of reoperation, the gallbladder is already removed and the repair is done using tissue grafts from elsewhere. The umbilical vein flap can be used for repair because it is easier to take the umbilical vein of the hepatic ligament, but the tissue is smaller and suitable for small-scale repair, but since the umbilical vein lining is a vascular endothelium, it remains to be seen whether long-term contact with bile can cause fibrosis and contracture. In addition, the more commonly used is the tipped jejunal flap, but the distance is farther, the separation of the vascular arch is longer and an intestinal anastomosis is needed, and the jejunal wall is thinner, so when the intestinal wall flap is too rich, it is easy to expand under the pressure of bile to form a pouch, and even stones occur. We believe that the gastric wall with blood flow is more suitable as the repair material for the bile duct. The gastric wall itself is relatively thick, divided into mucosal, submucosal, muscular and plasma layers in order, and is not prone to atrophy and restenosis. The gastric greater curvature or gastric lesser curvature can be used, and the part of the gastric wall on the side of the greater curvature is located in the area of the right artery of the gastric omentum close to the midline of the greater curvature, so that there can be a longer section of free vascular tip, which is convenient for high bile duct repair in the hilar region. Because of the thicker gastric flap local suture is more reliable, postoperative bile leak is less frequent and the surgical anastomosis is more satisfactory. In conclusion, the long-standing management of biliary defects in biliary surgery has been to replace them with jejunum for bile duct jejunal Roux-en-Y anastomosis. Most patients are satisfied in the long-term postoperative follow-up, but a small percentage develop reflux cholangitis. If bile duct repair is performed in patients with more normal distal bile ducts and sphincter function is preserved, the physiological function of the biliary tract will be better restored.