28th May 2025

A 62-year-old man presents to A&E with severe abdominal pain and vomiting.

A 62-year-old man presents to A&E with severe abdominal pain and vomiting. On examination, he is jaundiced and in considerable distress. He is generally tender across his abdomen, but particularly so in the right upper quadrant. A chest x-ray demonstrates pneumoperitoneum.

Which of the following is the definitive management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.