Obstructive jaundice is believed to be characterized by abnormalities of alkaline phosphatase (ALP), rather than aspartate transaminase (AST). Aim: To compare liver function tests (LFTs) in obstructive jaundice due to malignant strictures with those of jaundice due to gallstones. Methods: LFTs were measured immediately before endoscopic retrograde cholangio-pancreatography (ERCP) in 207 jaundiced patients. Group 1 (n ¼ 69) had malignant strictures, group 2 (n ¼ 97) had common bile duct

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... and group 3 (n ¼ 41) appeared to have recently passed a stone. LFTs in groups 2 and 3 were also analysed at maximal liver enzyme derangement, maximum hyperbilirubinaemia and during acute pain episodes. Results: Group 1 had higher median bilirubin, AST and ALP levels than groups 2 or 3 (p 5 0.001). In group 1, median rise in ALP exceeded that in AST (4.3Â normal upper limit (NUL) vs. 2.6Â NUL,