女，35岁。慢性胆囊炎病史。饱食后突起持续 性上腹部剧痛，痛引.两胁，恶心，呕吐，口干 苦。检查:体温38C，脉搏103次/分，血压110/70mmHg,腹部稍膨胀，剑突下有轻压痛 及反跳痛。舌淡红，苔白，脉弦细。血淀粉酶 600U/L (苏氏法）。首先考虑的诊断是

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