High total bilirubin and direct bilirubin are considered to be caused by hepatitis B, bile duct stones, pancreatic head tumor and other diseases, which can be treated by taking antiviral drugs and surgery after clear diagnosis. 1. Hepatitis B: Hepatitis B viral hepatitis is caused by hepatitis B virus infection which damages liver cells, bilirubin is metabolized in the liver, and bilirubin metabolism is impaired after liver cells are damaged, which results in high total bilirubin and direct bilirubin, and should be treated by antiviral medications such as entecavir and tenofovir under the guidance of a doctor. 2. Biliary tract stones: Biliary tract stones can cause bilirubin excretion channel obstruction, bilirubin backflow into blood, resulting in high total bilirubin and direct bilirubin, which can be treated by endoscopic papillary sphincterotomy and lithotripsy, and the total bilirubin and direct bilirubin will be lowered after the obstruction is relieved. 3. Pancreatic head tumor: the head of pancreas and bile duct are close to each other, the tumor of pancreatic head can compress the bile duct, leading to the obstruction of bile duct, causing bilirubin to flow back into the blood, resulting in the elevation of total bilirubin and direct bilirubin. Bilirubin can be normalized after removal of the tumor from the head of pancreas to relieve the obstruction. If the total bilirubin and direct bilirubin are both high, you should go to the hospital in time, complete the examination, and give targeted treatment after clarifying the cause of the disease.