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This is a pathology statement, likely from a doctor's report or medical exam notes. "Underlying" generally means the primary cause of a disease or condition, or the first step towards developing a disease or condition. "Biliary" refers to the production, collection, storage and release of bile in the liver and upper small intestines. "Dysfunction" refers to abnormal function - possibly less function, possibly more, possibly simply different function.

Putting all the words together, this refers to a starting point of a disease process involving the bile system in the liver not working like it should. Depending upon the disease process, this could be life altering.

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