A technique for biliary drainage in orthotopic liver transplantation has been developed in which the gall bladder is used as a pedicle graft between the donor and recipient common bile ducts. In 7 patients this technique has produced encouraging results. There has been no incidence of bile leakage or stenosis of the anastomoses. The gall bladder permits the widest possible anastomoses for obliquely cut ends of the donor and recipient common ducts. It eliminates tension and retains the advantage of the sphincter of Oddi. Although the followup is short, the incidence of biliary complications using other techniques has been so high that the procedure described here would appear to have distinct advantages.