患者，男性，岁，因急性腹痛数小时就 诊，超声检查显示胆囊内多发结石，胰腺 弥漫性肿大，回声减弱，不均匀，胰腺周 围可见弱回声带，脾静脉细窄；肠管扩张， 腹腔见大量积液，透声差。考虑最可能的 诊断为

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