A 42-year-old woman undergoes an abdominal ultrasound that shows a 12 mm pedunculated gallbladder polyp. She is asymptomatic and has no other findings. The most appropriate next step is:
- A Annual ultrasound surveillance
- B Repeat ultrasound after 6 weeks to confirm the finding is not sludge
- C Cholecystectomy ✓
- D Endoscopic ultrasonography followed by surveillance if unchanged
Correct answer: C. Cholecystectomy
Explanation
Gallbladder polyps of 10 mm or greater carry a significant risk of harboring malignancy and are an accepted indication for cholecystectomy regardless of symptoms. Polyps under 6 mm without risk factors can be safely observed, while those between 6 and 9 mm warrant surveillance, with earlier surgery if growth occurs. The 6-week repeat scan is used for apparent small polyps that may be biliary sludge, but a confirmed 12 mm polyp crosses the surgical threshold. Endoscopic ultrasound adds nothing once the size criterion for resection is met.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.