Objective To investigate the feasibility and efficacy of using the hepatoduodenal ligament tension-reduced operation (tension-reduced operation in short) for iatrogenic bile duct injury where the bile duct was severely defective. Methods Between March 2006 and May 2009, the authors treated 6 patients with iatrogenic bile duct injury (Bismuth type Ⅱ : 5 patients and type Ⅲ : 1 patient). A no. 7 black silk thread was used to hold the hilar plate tissues and the seromuscular layer of the bulbous part of the duodenum closer together and knots were tied. This method brought the porta hepatis and the duodenal bulb closer together and the hepatoduodenal ligament was shortened. An end to end anastomosis could then be made between the two broken ends of the defective bile duct without tension. Results Six patients suffered from bile duct injury and they recovered fully after the tensionreduced operation. There was no complication on follow-up. Conclusions The tension-reduced operation was efficacious in the treatment of iatrogenic bile duct injury. This technique should be popularized and more widely used.