The most appropriate management is cholecystectomy. The finding of a gallbladder polyp larger than 1 cm is an indication for cholecystectomy, even if the patient is asymptomatic. Gallbladder polyps are found in approximately 5% of ultrasound examinations. Although only a small percentage of gallbladder polyps are neoplastic (adenoma or adenocarcinoma), the risk for neoplasia increases as polyp size increases. In the absence of gallstones, a gallbladder polyp smaller than 1 cm can be followed with serial ultrasound examinations unless the patient is symptomatic or has primary sclerosing cholangitis. For patients with gallstones and any size polyp, cholecystectomy is usually recommended.

Further imaging with abdominal CT, endoscopic retrograde cholangiopancreatography, or magnetic resonance cholangiopancreatography is not necessary in this patient because she has an asymptomatic, incidental gallbladder polyp; however, these tests should be considered if this patient had symptoms or elevated liver chemistry tests suggesting bile duct obstruction or malignancy.