Objective To explore the feasibility and safety of laparoscopic cyst resection and Roux-en-Y hepatojejunostomy in treatment for adult congenital cholangiectasis and to compare the therapeutic effects of laparoscopic procedure with conventional open procedure. Methods The clinical data of 33 adult patients with congenital cholangiectasis from May 2008 to September 2011 in the department of general surgery of Shengjing Hospital of China Medical University were retrospectively analyzed. Fourteen patients received laparoscopic procedure （laparoscopic group），whereas the other 19 patients received conventional open procedure （conventional group）. Results All the operations were carried out successfully through laparoscopic procedure. The mean time of operation in the laparoscopic group was significantly longer than that in the conventional group （195min versus 130min，P＜0.01）. The average intraoperative blood loss in the laparoscopic group was significantly less than that in the conventional group （80ml versus 270ml，P＜0.01）. In contrast，the mean time of bowel peristalsis recovery and postoperative hospital stay in the laparoscopic group were significantly shorter than those in the conventional group （time of bowel motion recovery：76h versus 104 h，P＜0.01；hospital stay：6.1 d versus 9.6 d，P＜0.01）. There were no differences in the early complications between two groups （P＞0.05）. Conclusions Totally laparoscopic treatment for congenital cholangiectasis in adult is feasible and safe. It is worth to be generally applied because of its minimal invasion and fast postoperative recovery.