<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 44-year-old woman presents to the emergency department with severe, fluctuating right upper quadrant abdominal pain. The pain was initially a 410 but has increased recently to a 610 prompting her to come in. The patient has a past medical history of type II diabetes mellitus, depression, anxiety, and irritable bowel syndrome. Her current medications include metformin, glyburide, escitalopram and psyllium husks. On exam you note an obese woman with pain upon palpation of the right upper quadrant. The patients vital signs are a pulse of 95min, blood pressure of 13590 mmHg, respirations of 15min and 98 saturation on room air. Initial labs are sent off and the results are below:Na: 140 mEqLK: 4.0 mEqLCl-: 100 mEqLHCO3-: 24 mEqLAST: 100 ULALT: 110 ULAmylase: 30 ULAlkaline phosphatase: 125 ULBilirubinTotal: 2.5 mgdLDirect: 1.8 mgdLThe patient is sent for a right upper quadrant ultrasound demonstrating an absence of stones, no pericholecystic fluid, a normal gallbladder contour and no abnormalities noted in the common bile duct. MRCP with secretin infusion is performed demonstrating patent biliary and pancreatic ductal systems. Her lab values and clinical presentation remain unchanged 24 hours later. Which of the following is the best next step in management?? A: Elective cholecystectomy, B: Laparoscopy, C: ERCP with manometry, D: Analgesics and await resolution of symptoms, E: MRI of the abdomen,  <response>: Based on the information provided, this patient is presenting with right upper quadrant abdominal pain and lab abnormalities consistent with cholestasis elevated AST, ALT, alkaline phosphatase, and bilirubin. Imaging including ultrasound and MRCP did not reveal any anatomical abnormalities to explain the cholestasis. The next step in management would be to determine if there is a functional obstruction at the level of the sphincter of Oddi causing the cholestasis. ERCP with manometry allows direct measurement of the sphincter of Oddi pressures to diagnose sphincter of Oddi dysfunction. Therefore, ERCP with manometry is the best next step in diagnosing the cause of this patients cholestatic liver enzymes.C: ERCP with manometry 