Obstructive jaundice induced by hilar cholangiocarcinoma (HCCA) often requires preoperative or palliative biliary decompression. Percutaneous transhepatic biliary drainage (PTBD) with external drainage is one of the most widely adopted modalities at present. Nevertheless, long-term massive extrahepatic bile loss may trigger water-electrolyte disorders, steatorrhea and impairment of the intestinal barrier. The bile reinfusion (BR) technique forms a closed loop of "extracorporeal drainage and intracorporeal reinfusion", which can theoretically restore the enterohepatic circulation, preserve intestinal microecology and improve nutritional status. This paper systematically reviews published clinical trials, experimental studies and meta-analyses in recent years, and summarizes the indications, technical protocols, efficacy evidence and potential risks of BR after PTBD in patients with HCCA, so as to provide references for clinical practice and future research.