Objective: To evaluate the clinical efficacy of ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage for liver abscess after Roux-en-Y hepaticojejunostomy. Methods: The clinical data of 20 patients with liver abscess after Roux-en-Y hepaticojejunostomy undergoing ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage from January 2012 to January 2014 were retrospectively analyzed. Results: In all 20 patients, catheterization was successfully performed, the symptoms of pain were alleviated 24–48 h after catheterization, body temperature returned to normal, and the symptoms of pain and chills disappeared 48–72 h after catheterization; white blood cell levels returned to normal range 72–96 h after catheterization, and no tube blockage or partial blockage occurred during the continuous drainage. The tube retention time ranged from 11 d to one month, with an average of 14 d. No serious complications such as hemorrhage or surrounding organ injuries were noted in any of the 20 patients. Conclusion: Interventional ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage is a reliable and effective management for liver abscess after Roux-en-Y hepaticojejunostomy.