High transaminase after ERCP surgery needs to be judged comprehensively according to the severity of the disease and the patient’s physical condition, to find out the cause, and then according to the actual situation to carry out the treatment for the cause, of which the more commonly used methods are rest, entegravir, adenosylmethionine and other medications, as well as surgical treatment. The high transaminase after ERCP is most likely due to the patient’s underlying liver disease, such as chronic hepatitis, which causes stimulation of the hepatobiliary system during the ERCP procedure. In addition, if the patient does not pay attention to his/her own care after the surgery and drinks alcohol freely, it may also lead to liver cell damage, which in turn may lead to the problem of elevated transaminases. Generally speaking, if the elevation of aminotransferases is not high, most of them will gradually return to normal in a short period of time. However, if the elevation is obvious, it is necessary to go to the hospital for examination, identify the cause of the disease, and then carry out targeted treatment. For patients suffering from chronic hepatitis, antiviral drug treatment should be carried out in time, and take some drugs as prescribed by the doctor, such as tenofovir, entecavir, etc., and if necessary, they also need to go to the hospital for surgical treatment. In normal times, patients should maintain a healthy diet and lifestyle, quit smoking and drinking in time, eat less spicy and greasy food, such as hot pot, fried chicken, etc., and pay attention to rest, try not to stay up late to avoid unnecessary burden on the liver.