OBJECTIVES To investigate the selection of the types of anastomosis and to evaluate the therapeutic effects of portoenterostomy. METHODS From 1993 to 1998, 426 patients with obstructive jaundice underwent portoenterostomy. The patients included 236 cases (56%) of hilar strictures in hepatolithiasis, 98 cases (23%) of end-stage periampullary tumors, 64 cases (15%) of proximal cholangiocarcinoma, and 28 cases (6%) of congenital choledochus cyst. Reconstruction of biliary tract was performed after resection of affected duct or palliative bypass for end-stage carcinoma. The types of anastomosis included extra or hilar hepatic bilioenterostomy (160 cases, 37%), and intra-hepatic duct anastomosis with different type of hepatectomy (266 cases, 63%), in which anastomosis was performed by round ligament approach (34 cases, 8%), and anastomosis through gallbladder fossa (15 cases, 4%). RESULTS Short- and 1-6 year follow-up showed that jaundice of patients was completely relieved by suitable type of bilioenterostomy. CONCLUSIONS The good therapeutic effects of bilioenterostomy are based on the correct selection of anastomosis methods.