A 46-year-old woman was admitted yesterday with epigastric pain and a serum lipase of 3,400 U/L (<60). Ultrasound showed multiple gallbladder stones and a common bile duct of 11 mm. Overnight she has developed rigors; her temperature is 39.1 °C, pulse 118/min and blood pressure 96/58 mmHg despite fluids. Bilirubin has risen from 48 to 112 µmol/L (<20), alkaline phosphatase is 510 U/L (30–110), and white cell count is 21 × 10⁹/L. She is confused.
Which one of the following is the most appropriate next step in management?
Keep going — a set of ten like this one, one at a time.
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