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- ArticleLilly JR.Ann Surg. 1977 Nov;186(5):549-58.The surgery of congenital malformations of the biliary system has undergone a revolutionary change during the past decade. Although Kasai's hepatic portoenterostomy operation for biliary atresia is the most dramatic example, radical departures from conventional surgical treatment also have been advocated for choledochal cyst, Caroli's disease, congenital perforation of the bile ducts and biliary hypoplasia. This communication describes the lesions responsible for obstructive jaundice in the early months of life, briefly reviews standard treatment and consolidates the available information about the new operative procedures currently proposed for congenital anomalies of the biliary tract.