A 76-year-old woman presented to the Emergency Department with 2-week history of epigastric discomfort, obstructive jaundice and gastric outlet symptoms. She denied fever but had loss of weight and appetite. She was clinically cachexic with jaundice but no signs of chronic liver disease. There was a palpable gallbladder with positive succussion splash. No supraclavicular lymph node felt. She was biochemically obstructed with total bilirubin of 290 and direct bilirubin of 230. Liver transaminases were within normal range. Tumour markers namely CA 19-9 was 120 U/mL (<37) and CEA was 2.1 ng/mL (<5). The hepatitis screening was nonreactive. Spot the radiological diagnosis and briefly how to manage?