Objective To investigate the dynamic changes in tumor necrosis factor-alpha (TNF α) and interleukin-6 (IL-6) levels in bile and serum of patients with acute obstructive suppurative cholangitis (AOSC) and evaluate the clinical significance of these factors.Methods Thirty patients diagnosed with AOSC by endoscopic retrograde cholangiopancreatogram (ERCP) and 40 patients classified as non-AOSC by ERCP (controls) were enrolled in the study.The double-antibody sandwich enzyme-linked immunosorbent assay was used to measure TNF α and IL-6 content in bile and serum samples taken at study enrollment (baseline, for AOSC and non-AOSC groups) and four days after surgery (for AOSC group) .Results The AOSC group showed significantly higher baseline content of TNF α (bile: 179.25±26.50 pg/ml, serum: 189.14±28.89 pg/ml) and IL-6 (bile: 207±42.05 pg/ml, serum: 420.18±89.04 pg/ml) than the control group (TNF α bile: 4.02±2.17 pg/ml, serum: 8.16±2.29 pg/ml;IL-6 bile: 7.48±3.89 pg/ml, serum: 14.92±4.73 pg/ml) (all P<0.01) .In addition, the AOSC group showed significantly reduced levels of TNF α and IL-6 in bile on the fourth day after surgery (vs.baseline, P<0.01) .Conclusion AOSC patients have enhanced levels of TNF α and IL-6 in both serum and bile, suggesting that these two inflammation-related cytokine factors may be involved in the disease pathophysiology.Future studies should investigate whether TNF α and IL-6 can be used as diagnostic markers of AOSC.