The goal of these surgeries is to decrease the amount of bile salts being reabsorbed by the body. This is done by interrupting the recirculation of bile acids. These surgeries may be considered when medication is insufficient. Whether surgery is best for you/your child should be determined by you and your medical team. There are different benefits and burdens regarding each surgery. Long-term, real-world experience with these approaches in larger populations will hopefully be able to provide clarity as to how these interventions impact disease natural history and patient outcomes.