A 42-year-old woman undergoes a routine abdominal ultrasound that shows a 12 mm pedunculated polyp arising from the gallbladder wall, with a single feeding vessel on colour Doppler. She is otherwise asymptomatic. What is the most appropriate management?

• A Repeat ultrasound at 6 months and proceed only if the polyp exceeds 15 mm
• B Laparoscopic cholecystectomy ✓
• C Ursodeoxycholic acid for 6 months followed by repeat scan
• D Annual surveillance for 5 years before considering surgery

Explanation

Gallbladder polyps of 10 mm or larger carry a significant risk of being malignant adenomas or early carcinoma, and guidelines recommend cholecystectomy regardless of symptoms. A vascular pedicle further favours an adenomatous rather than cholesterol polyp. Surveillance is reserved for polyps under 10 mm without risk factors such as age above 50, Indian ethnicity, primary sclerosing cholangitis or a solitary sessile polyp.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.