Total excision of a type I choledochal cyst with reconstruction via a Roux-en-Y hepaticojejunostomy is shown in a 16-month-old child. Emphasis is placed upon the technical features and feasibility of circumferential dissection with total transmural excision, rather than subtotal excision, leaving the posterior and medial walls in sit u, as has been advocated. In addition, the dissection of the distal cyst and the anomalous junction with the pancreatic duct are clearly demonstrated.