A 48-year-old man undergoes ultrasound for vague dyspepsia. A single pedunculated gallbladder polyp measuring 12 mm is seen, with no other abnormality. The most appropriate management is:

• A Cholecystectomy ✓
• B Annual ultrasound surveillance
• C Repeat ultrasound after 6 months, operate only if it exceeds 15 mm
• D Reassurance, as all gallbladder polyps are benign cholesterol polyps

Explanation

Polyp size drives management because malignant potential rises sharply above 10 mm. B polyp of 12 mm exceeds the accepted threshold for cholecystectomy regardless of symptoms, since size is the strongest predictor of occult malignancy. Surveillance is reserved for polyps under 10 mm without risk factors such as age over 50, Indian ethnicity, sessile morphology, or solitary status, several of which this patient already has.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.