An abdominal ultrasound performed for dyspepsia in a 42-year-old woman shows a single pedunculated polypoid lesion arising from the gallbladder wall measuring 14 mm. There are no gallstones and she has no symptoms. The most appropriate management is:
- A Repeat ultrasound in 12 months
- B Ursodeoxycholic acid dissolution therapy
- C Cholecystectomy ✓
- D Endoscopic ultrasound-guided fine needle aspiration as definitive treatment
Correct answer: C. Cholecystectomy
Explanation
Gallbladder polyps larger than 10 mm carry a significant risk of harbouring carcinoma, so cholecystectomy is recommended for any patient fit for surgery. Polyps under 6 mm without risk factors need no follow-up, and intermediate sizes warrant periodic ultrasound surveillance. Ursodeoxycholic acid dissolves cholesterol stones, not polyps, and has no role here. Diagnosis of a malignant polyp ultimately rests on histology of the resected specimen, and aspiration is not a treatment modality for these lesions.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.