患者男，65岁。腹痛4个月，黄疸、陶土样大便半个月。检查巩膜、皮肤黄染，心肺未见异常，上腹部轻度压痛，未及包块。CT检查肝内胆管扩张，胆总管中上段扩张，下端狭窄，未见阳性胆结石；MRCP肝内外胆管软藤状扩张，下端狭窄，局部胆管壁增厚。应该考虑为：

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