Percutaneous Cholecystostomy for Acute Cholecystitis During Spaceflight.

Area of Science:

• Space Medicine
• Surgical Emergencies
• Gastroenterology

Background:

• Acute calculous cholecystitis is a common surgical emergency.
• Cholecystectomy is the standard treatment.
• Percutaneous cholecystostomy tube (PCT) placement is an alternative for high-risk patients or remote environments like space.

Purpose of the Study:

• To review the literature on the terrestrial efficacy of PCT for acute calculous cholecystitis.
• To assess the theoretical utility of PCT for treating acute cholecystitis during long-duration spaceflight, lunar, or Martian missions.

Main Methods:

• Systematic review of 16 peer-reviewed articles published since 2018.
• Focus on terrestrial efficacy and outcomes of PCT placement for acute calculous cholecystitis.

Main Results:

• Mean initial clinical success rate of PCT was 89.9%.
• High rates of recurrent cholecystitis (15.8%), need for interval cholecystectomy (35.6%), and complications requiring repeat interventions (18.6%) were observed.
• Mean 30-day mortality was 9.6%.

Conclusions:

• PCT provides high initial success but has poor long-term outcomes, including recurrence and complications.
• While feasible for short-term space missions (e.g., cislunar), PCT is likely inadequate for long-duration missions (e.g., Mars).
• Prophylactic cholecystectomy, in-space surgical capabilities, or preflight screening for gallstones are recommended for long-duration spaceflight.