A 55-year-old woman is found to have an incidental 1.5 cm gallbladder polyp on ultrasound. She has no symptoms. Which management is MOST appropriate?
- A Observe with repeat ultrasound in 12 months regardless of characteristics
- B Cholecystectomy is indicated for all polyps >1 cm due to malignancy risk ✓
- C ERCP to evaluate the bile duct for related pathology
- D MRI abdomen for further characterisation
Correct answer: B. Cholecystectomy is indicated for all polyps >1 cm due to malignancy risk
Explanation
Gallbladder polyps >10 mm (1 cm) carry a significant risk of being adenomatous and potentially malignant. European guidelines (ESGAR 2022) recommend cholecystectomy for all polyps ≥10 mm, or smaller polyps in patients with gallstones, primary sclerosing cholangitis, or polyp growth >2 mm on serial imaging. This 1.5 cm polyp clearly exceeds the 10 mm threshold and warrants cholecystectomy. Polyps <5 mm have very low malignancy risk and can be observed.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.