Which laboratory finding is most indicative of jaundice associated with postoperative cholestasis?

The most indicative laboratory finding of jaundice associated with postoperative cholestasis is elevated serum bilirubin levels. In the context of cholestasis, the liver's ability to excrete bile is impaired, leading to a buildup of bilirubin in the bloodstream. This accumulation manifests as jaundice, characterized by yellowing of the skin and sclera, which is closely tied to the elevation of serum bilirubin.

In specific cases of postoperative cholestasis, this bilirubin elevation primarily consists of conjugated (direct) bilirubin due to the liver's failure to adequately process and transport bile, not because there is a problem with bilirubin production. Hence, when jaundice occurs in this setting, monitoring serum bilirubin levels provides a clear indication of cholestasis.

While low albumin levels and high creatinine levels can indicate other underlying issues, they do not specifically point to cholestasis as strongly as elevated serum bilirubin. Normal alkaline phosphatase levels would typically not be expected in a case of cholestasis, where one would anticipate elevated alkaline phosphatase due to bile duct obstruction or liver dysfunction. Thus, elevated serum bilirubin stands out as a key indicator of jaundice stemming from postoperative cholestasis.