A 45-year-old man undergoing ultrasound for vague dyspepsia is found to have a single 13 mm sessile polyp arising from the gallbladder wall. He is asymptomatic. The most appropriate management is:

• A Laparoscopic cholecystectomy ✓
• B Repeat ultrasound after 6 months
• C Ursodeoxycholic acid for 6 months then repeat scan
• D Annual ultrasound surveillance indefinitely

Explanation

B gallbladder polyp of 10 mm or larger carries a substantial risk of being malignant and is an accepted indication for cholecystectomy regardless of symptoms. Sessile morphology further raises concern for adenoma or early carcinoma. Surveillance intervals are reserved for smaller polyps below 6 to 9 mm in patients without risk factors, and ursodiol does not regress true polyps.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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