Patients with primary sclerosing cholangitis who develop gallbladder polyps face a substantially elevated risk of malignancy and dysplasia compared with the general population. Certain polyp characteristics — size, growth trajectory, and imaging enhancement pattern — define when intervention becomes necessary.
This protocol addresses PSC patients with any of the following: a gallbladder polyp ≥8 mm in size; a smaller gallbladder polyp that is growing in size on follow-up imaging; or a contrast-enhancing gallbladder polyp, regardless of its current size.
In this setting, the recommended approach involves a surgical intervention targeting the gallbladder, given the high risk of malignancy or dysplasia associated with these polyp features. For contrast-enhancing polyps specifically, this consideration applies independent of polyp size.