CRP and Hyperbilirubinemia: Laboratory investigations at this time demonstrated direct hyperbilirubinemia (total bilirubin: 8.8 mg/dL; RI: 1.3 mg/dL, direct: 6 mg/dL; RI: <0.3 mg/dL) and elevated acute-phase reactants (C-reactive protein (CRP): 280 mg/L, RI: <5 mg/dL), indicative of ongoing biliary obstruction and systemic inflammation (Table 1).