Which bilirubin level is expected to be normal in patients with gallstone disease?

In patients with gallstone disease, the expected normal bilirubin level is unconjugated bilirubin. This is primarily because gallstones often lead to obstruction of the bile duct, which can result in the buildup of conjugated bilirubin when the bile flow is interrupted.

In contrast, unconjugated bilirubin, which is produced from the breakdown of hemoglobin, is typically not affected in gallstone disease unless there are other underlying conditions contributing to hemolysis. Therefore, unconjugated bilirubin levels remain normal while conjugated bilirubin levels may rise due to biliary obstruction.

This understanding of bilirubin metabolism is crucial in distinguishing between various types of liver and biliary conditions. In gallstone disease, it is common for health professionals to monitor total bilirubin levels along with fractions, leading to the realization that unconjugated bilirubin remains within normal limits.