A 48-year-old man undergoes ultrasonography for vague dyspepsia. A single pedunculated polyp measuring 14 mm is seen in the body of the gallbladder. He has no other complaints. The most appropriate recommendation is:

• A Annual ultrasound surveillance indefinitely
• B Repeat ultrasound after 3 months, operate only if it grows
• C Reassurance, as gallbladder polyps are always benign
• D Cholecystectomy ✓

Explanation

A gallbladder polyp of 10 mm or more is an accepted indication for cholecystectomy because the risk of malignancy rises sharply above this size, particularly when the polyp is solitary, sessile, or accompanied by age over 50 or primary sclerosing cholangitis. Surveillance is reasonable for polyps below 10 mm without risk factors. Reassurance alone ignores the malignant potential of large polyps, and waiting for documented growth in a 14 mm lesion would miss the window for early cancer detection.

Reference: Sabiston Textbook of Surgery, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.