Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1150
Peer-review started: October 15, 2023
First decision: December 15, 2023
Revised: December 26, 2023
Accepted: January 22, 2024
Article in press: January 22, 2024
Published online: February 26, 2024
Processing time: 127 Days and 22.5 Hours
Core Tip: Clinically, giant congenital biliary dilation (CBD) is a rare condition compared to ordinary CBD. There are numerous research articles discussing surgical treatment options for common CBD. The choice of specific surgical method should be based on the individual circumstances of the hospital, the child, and the family members. In our case report, we present the experience of treating a very young child (11 d old) with a significantly dilated biliary tract. The overall condition of the child before the operation was critical. During laparoscopic biliary reconstruction, we encountered a thin and ulcerated cyst wall, making separation and bleeding control challenging. Therefore, we opted for an open laparotomy and performed a Roux-en-Y anastomosis between the common hepatic duct and jejunum. Taking into consideration the analysis of similar cases indexed in PubMed, we suggest that open surgery is more advantageous than laparoscopic treatment for children with giant CBD who are in critical condition and have severe biliary tract distortion.