A 55-year-old woman comes to the emergency department because of a 3-day history of chills and spiking fever. She is clinically jaundiced, and the laboratory shows total bilirubin of 8 mg/dL, with 6mg/dL direct, minimally elevated transaminases, and at enfold elevation in the alkaline phosphatase. Sonogram reveals extremely dilated intrahepatic ducts, but the common duct could not be visualized. Three months prior to this episode she had undergone a laparoscopic cholecystectomy for symptomatic gallstones at another hospital. She was told that the operation had gone well and that intra operativex-rays showed no stones elsewhere, but 10 days after surgery she was operated again because she had become deeply jaundiced. The second operation was an open laparotomy, but she does not know exactly what was found or done. Which of the following is the most likely diagnosis at this time?
A. Hepatic abscess
B. Hepatitis
C. Iatrogenic stricture of the common duct
D. Retained stones
E. Subphrenic abscess
A. Hepatic abscess
B. Hepatitis
C. Iatrogenic stricture of the common duct
D. Retained stones
E. Subphrenic abscess