The gold standard treatment for choledocal cysts is total cyst excision and cholecystectomy. Associated malignancy warrants more extensive surgery such as Whipple’s operation for lower common bile duct cancer or hepatectomy for proximal bile duct cancer or gallbladder cancer. Roux-en-Y hepaticojejunostomy or, less commonly, hepaticoduodenostomy is indicated to restore biliary drainage. For patients with symptoms of pain and jaundice, effective drainage of the common bile duct and pancreatic duct can be achieved by endoscopic sphincterotomy or operative laporotomy. For long-term prophylaxis and to treat cholangitis, antibiotics are helpful. [extracted from the text]