A 52-year-old woman presents to the emergency department with severe right upper quadrant abdominal pain and jaundice. History of Present Illness: The patient reports experiencing intermittent episodes of dull abdominal pain over the past few weeks, which she attributed to fatty meals. However, 24 hours ago, the pain became severe, constant, and radiated to her back. She noticed her urine turning dark and her stools becoming pale. She denies fever, nausea, or vomiting. Past Medical History: •Gallstones diagnosed 2 years ago (no prior intervention). •Hypertension, controlled with medication. Social History: •Non-smoker, occasional alcohol use. •Works as a teacher and denies recent travel. Physical Examination: •Vital signs: BP 125/80 mmHg, HR 96 bpm, Temp 98.7°F, RR 18 breaths/min. •General: Appears uncomfortable but alert. •Abdominal exam: Marked tenderness in the right upper quadrant, positive Murphy’s sign, no palpable masses. •Skin: Icteric sclera and mild jaundice.Laboratory Findings: •Liver enzymes: ALT 150 U/L, AST 130 U/L, ALP 420 U/L, GGT 350 U/L. •Bilirubin: Total 4.8 mg/dL (direct 3.8 mg/dL). •WBC: 8,000/mm³. •Lipase: Normal. Imaging: • Abdominal ultrasound: Dilated common bile duct (CBD) measuring 10 mm, no clear stones visualized. MRCP confirms the presence of a CBD stone. What is the definitive treatment for her condition?
