Abstract A prospective random ised study of end-to-end bile duct reconstruction with or without T-tube drainage during orthotopic liver transplantation (OLT) was un dertaken in 60 patients well matched for age, sex, aetiology of liver dis ease, operative blood loss, cold is-chaemic time, preoperative serum bilirubin level and Child-Pugh score. Significant biliary complications in the T tube group occurred in five patients and included bile duct stricture (n = 2), bile leakiperitonitis (n = 1) and cholangitis (n= 2). Bile duct strictures occurred in six patients in the no T tube group (P > 0.05, NS). Hepatic artery stenosis was identified in one patient from each group in association with a biliary stricture. Biliary complications in both groups were associated with a prolong ed graft cold ischaemic time (P</i> < 0.01). As no significant difference was noted in the number of early and late biliary complications between the two groups, the routine use of a T tube has been discontinued.