Suggested approach to the management of gallbladder polyps in adults

* Gallbladder polyps ≥10 mm have an increased risk of malignancy. For polyps ≥10 to 20 mm, laparoscopic cholecystectomy with full thickness dissection is indicated. For polyps >20 mm, an extended cholecystectomy with lymph node dissection and partial hepatic resection in the gallbladder bed is indicated.
¶ For example, cholecystectomy is indicated in patients with primary sclerosing cholangitis with gallbladder polyps >8 mm. Refer to UpToDate text for additional information related to the approach to gallbladder polyps in patients with primary sclerosing cholangitis.
Δ An increase in size of >2 mm on imaging is likely to represent a clinically relevant increase in size and should prompt referral to a surgeon for cholecystectomy.
◊ In patients who are unable or unwilling to undergo cholecystectomy, we perform a surveillance ultrasound at 6 months and then annually if stable in size.