A 50-year-old woman is found to have a 3.5 cm gallbladder polyp on ultrasound, with echogenic foci (no acoustic shadow) and no wall thickening. She has no symptoms. The most appropriate management is:

• A Repeat ultrasound in 12 months
• B MRCP to characterise the polyp
• C Open cholecystectomy with resection of the adjacent liver bed
• D Laparoscopic cholecystectomy ✓

Explanation

Gallbladder polyps ≥10 mm carry a significant risk of malignancy and require cholecystectomy. A 3.5 cm polyp far exceeds this threshold and laparoscopic cholecystectomy is indicated. Open resection with liver bed excision would be appropriate if carcinoma is confirmed (T2 or greater), but the initial surgery is laparoscopic cholecystectomy with careful specimen extraction to avoid bile spillage.

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.