This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. We have studied 137 consecutive cases in which anastomosis of the biliary and the gastro-intestinal tracts was carried out at the Mayo Clinic from 1919 to 1924 inclusive. We wished to ascertain, if possible, the end-results of these operations and any other related data which might be correlated and used in the interpretation of the clinical and pathologic manifestations of the various lesions. Obviously, in such a series there are many complications, great technical difficulties and a high mortality rate. The malignant cases were hopeless and the patients were usually in extremely poor general health when they presented themselves for treatment. Many of them were jaundiced and had had previous operations, some of which had caused their chief complaint, as for example, strictures. All were poor risks and required heroic measures for cure, or even for some degree of relief. Every patient with jaundice, or who had recently been jaundiced,