Ultrasound in a 45-year-old man performed for unrelated dyspepsia shows a single 14 mm sessile gallbladder polyp with no stones and a normal wall. He is asymptomatic. The most appropriate management is:
- A Reassurance with no follow-up
- B Annual ultrasound surveillance indefinitely
- C Cholecystectomy ✓
- D Ursodeoxycholic acid for 6 months then repeat scan
Correct answer: C. Cholecystectomy
Explanation
Gallbladder polyps of 10 mm or larger carry a significant risk of malignancy and are an accepted indication for cholecystectomy regardless of symptoms, particularly sessile lesions. Polyps under 6 mm can be discharged, and those between 6 and 9 mm warrant surveillance. Ursodeoxycholic acid does not resolve true polyps, since it dissolves cholesterol stones rather than mucosal lesions, and indefinite surveillance of a lesion already past the resection threshold delays diagnosis.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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