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The e-mémoires of the Académie Nationale de Chirurgie

Place of silicone prosthesis (KRON’s biliary prosthesis) in the repair of a section of the common bile duct.

Bernard KRON

Seance of wednesday 11 september 2024 (Communications libres)

DOI number : 10.26299/a2qz-sy60/emem.2024.23.06

Abstract

Henri Bismuth and Laurence Chiche presented to the ANC around thirty liver transplants following serious surgical damage to the biliary junction. They did not mention the possible reconstruction of biliary continuity with a silicone prosthesis in the event of section of the unknown common bile duct.
The characteristic of silicone is its low surface energy which prevents clogging. I demonstrated this during an experimental study on 25 dogs (1970/1974). It was presented to the ANC in 1974 (Pr. Marcel Roux, Rapporteur - Mondor Prize in 1977). The bile duct was perfectly reconstituted and remained functional after removal of the prosthesis (anapath. Pr. Étienne Martin).
Their reliability has been demonstrated in bypass grafts for neoplastic jaundice with more than 500 observations collected. I therefore ask this question: should we not reconstruct the continuity of the VBP with a silicone prosthesis? When the bile duct is thin during revision surgery, the situation does not lend itself to suturing or a Y loop. Expert centers should consider this.
Bibliography:
Segmental replacement of the extrahepatic bile duct in dogs with a silicone elastomer prosthesis. Its possible applications in biliary surgery. ANC. 1974. B. Kron.
The KRON’s prosthesis. Alternative to biliary diversion - J. Cady and B. Kron 86th French congress of surgery. September 24-27, 1984