Thank you for all your hard work last week. I don’t think we _____ it without you.

A．can manage

B．could have managed

C．could manage

D．can have managed

男性，40岁，有明显黄疸，皮肤瘙痒1个月，粪便颜色变浅，伴轻度乏力，腹胀，肝肋下触及2cm，脾侧未及，ALT120U/L，胆红素定量230μmol/L，碱性磷酸酶、γˉGT、胆固醇增高。此患者主要需和哪种疾病鉴别【 】

A．急性黄疸型肝炎

B．胆囊炎

C．肝汁性肝硬化

D．肝吸虫病

E．肝外梗阻性黄疸