Gallbladder polyp — ESEGH MCQ
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Correct answer: B — Urgent specialist hepatobiliary surgical assessment
The best answer is “Urgent specialist hepatobiliary surgical assessment”. PSC changes the malignancy threshold: even a sub-centimetre gallbladder lesion needs prompt specialist assessment. “Return to routine care given the polyp is below 10 mm” is less appropriate because PSC substantially increases gallbladder neoplasia risk “Repeat ultrasound in 5 years” is less appropriate because this interval is unsafe in a high-risk PSC context “ERCP with transpapillary gallbladder-polyp biopsy” is less appropriate because ERCP is not a reliable sampling method for a mural gallbladder lesion “Treat with ursodeoxycholic acid and assume resolution” is less appropriate because medical therapy does not eliminate a suspicious polyp
Reference: BSG/UK-PSC guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC6691863/