Phenobarbital Treatment for Prolonged Cholestatic Jaundice After Endoscopic Retrograde Cholangiopancreatography

Prolonged cholestatic jaundice after endoscopic retrograde cholangiopancreatography (ERCP) is a rare and clinically challenging condition when mechanical obstruction is excluded. While its pathophysiology remains unclear and no established treatment strategy exists, we describe a patient with persistent post-ERCP cholestasis whose hyperbilirubinemia improved markedly after initiation of phenobarbital. The total bilirubin level decreased from a peak of 29.8 mg/dL to 23.9 mg/dL within 5 days and continued to decline thereafter. This suggests that phenobarbital could be a potential therapeutic option for prolonged post-ERCP cholestasis when conventional treatments, such as ursodeoxycholic acid and herbal medicine, are ineffective.