A 42-year-old woman undergoes an abdominal ultrasound for vague dyspepsia. The gallbladder contains a single pedunculated polyp measuring 12 mm. She has no biliary symptoms. What is the most appropriate management?

• A Cholecystectomy ✓
• B Ursodeoxycholic acid for six months
• C Repeat ultrasound after 12 months
• D Percutaneous needle aspiration of the polyp

Explanation

C gallbladder polyp of 10 mm or larger carries a significant risk of malignancy and is an accepted indication for cholecystectomy even when asymptomatic. Polyps below 6 mm without risk factors can be followed by serial ultrasound, so a 12 mm lesion should not be observed. Ursodiol dissolves cholesterol stones but has no effect on polyps, and aspiration is not a recognized treatment.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.