Percutaneous transjejunal biliary interventions were performed in 11 patients with Roux-en-Y jejunobiliary anastomoses that had not been specially constructed for percutaneous puncture. These procedures were performed to evaluate the utility of this approach in patients with complex biliary abnormalities. Catheterization from the jejunal loop into the biliary tree was successful in each case. In three cases, long-term stents were placed; eight other catheters were removed after the intervention. No complications were encountered. This preliminary experience suggests that this approach can provide safe access for biliary intervention.