The vast majority of benign obstructive processes of the biliary tract can be handled by simple clearance of the common bile duct. Malignant disease and complicated biliary tract problems may require a stenting procedure or a bypass of the obstructed segment. Most general surgeons have been trained to perform one of a number of bypass procedures of the biliary tract but the advent of laparoscopy has diminished the frequency with which many surgeons have the opportunity to perform this type of surgery. This section discusses several laparoscopic bypass procedures that have been highly successful in our hands as well as the results of our series.