Choledochal cyst, also known as cystic dilatation of the common bile duct, is a congenital developmental malformation of the bile duct, which was described by Vater in 1723. After the diagnosis of this disease, in principle, cystectomy and high bile-intestinal anastomosis should be used as much as possible; only in cases of combined biliary cirrhosis, portal hypertension, malignancy, etc., where resection is really difficult, where forcible resection may damage the surrounding important tissues, or in the acute infection stage, simple drainage is adopted. However, in a review of the patients with choledochal cysts operated by the author, most of them underwent 1 or even several incomplete surgical procedures before coming to our hospital for cyst removal, mainly by: 1) cystotomy for stone extraction and T-tube drainage; 2) choledochal cyst-duodenal anastomosis; 3) some patients also underwent repeated endoscopic treatment such as stone extraction under ERCP. Patients who underwent these treatment procedures had recurrence of stones and recurrent cholangitis within a few months at the earliest and required another biliary surgery as a last resort. If open biliary surgery has been performed previously, reoperation of the biliary tract can be challenging for both the doctor and the patient. First, because the first surgery was unsuccessful, patients will be resistant to future surgeries and have a great psychological burden. Second, the biliary tract itself is a very delicate and fragile organ, and the anatomical structure is obviously changed after surgery, and organs such as duodenum, gastric omentum, and colon will be closely adhered to the dirty surface of the liver and the hepatic portal, and there is a possibility of damage in the anatomy, resulting in postoperative biliary leakage and intestinal fistula, which is very difficult to heal. Third: Due to intraoperative infectious bile extravasation and poor healing of surgical scars, postoperative wound infection, abdominal infection, sepsis, etc. are very likely to occur. Therefore, I believe that surgeons, especially general surgeons in primary hospitals, should be highly vigilant for a disease like choledochal cyst because it is very easily confused with common bile duct stones secondary to biliary dilatation. Ultrasound examination alone before biliary surgery is not available because the surgeon cannot read the film in real time and cannot obtain the “biliary tree”, so imaging examinations such as CT or MRCP should be performed. In patients with acute biliary tract infection, PTCD or nasobiliary drainage under ERCP should be preferred to avoid blind and unnecessary open biliary tract explorations. The attending surgeon should be cautious in performing biliary surgery without adequate experience in bile-intestinal anastomosis. In addition, hemostatic materials such as non-absorbable or slowly degraded and absorbed chemical glues should also be used with caution after hepatic biliary surgery because the use of these materials often results in the formation of severe abdominal adhesions that are difficult to separate because of chemically reactive inflammation. In conclusion, although choledochal cyst is a relatively rare biliary tract disease, if it is diagnosed and treated appropriately before the first surgery, recurrent biliary tract infections, stone formation and malignancy in the future can be avoided and treated with good results. For this disease, the surgeon should try to perform a complete surgical removal of the lesion.