Complete resection of the cyst with hepatic duct jejunostomy Roux-Y anastomosis is the standard procedure for the radical treatment of choledochal cysts with good postoperative results.Yamataka et al. followed up 210 pediatric patients and 100 adult patients treated surgically and found that postoperative complications occurred in 9.0% of pediatric patients and 42.5% of adult patients, and the incidence of postoperative complications was lower in children than in adults ( p< 0.0001), indicating the importance of early surgery. Twenty-five postoperative complications occurred in pediatric patients, including cholangitis, intrahepatic bile duct stones, pancreatitis, stones in the common bile duct or pancreatic duct at the end of the pancreas, and intestinal obstruction. In contrast, adult patients had 27 postoperative complications. Only 14.5% of children who underwent surgery after the age of 5 years had stones in the biliary system, while 17.5% of adult cases had stone formation. Of the children who had postoperative complications, 15 underwent reoperation (four underwent enlargement of the hepatic duct-jejunostomy, one underwent percutaneous hepatic perforation cholangiography and stone extraction, two underwent resection of the stump of the common bile duct in the pancreas, one underwent endoscopy of the papilla in the jugular region, one underwent pancreatic duct-jejunostomy, and six underwent open intestinal obstruction release with release of adhesions). The occurrence of postoperative cholangitis and intrahepatic bile duct stones was closely related to the degree of stenosis of the anastomosis, common bile duct or intrahepatic bile duct. Anastomotic stenosis can lead to severe mucosal exfoliation of the common hepatic duct and prolonged inflammation of the intrahepatic bile ducts and result in biliary stasis. To avoid restenosis of the anastomosis, hepatic ductal jejunostomy should be performed at the level of the hepatic portal. After excision of the stenotic segment of the common hepatic duct, the anastomosis is performed by widening the opening of the hepatic duct along the anterior wall of the hepatic duct.