Negative Pressure Suction in ERCP Brush Cytology: Assessing its Impact on Biliary Stricture Diagnostics

Abstract Objective: To evaluate the effectiveness of negative pressure suction in improving the diagnostic yield of brush cytology for biliary strictures. Methods: We conducted a prospective study on 48 patients undergoing ERCP. Participants were divided into two groups: those undergoing standard brush cytology (CP group) and those with additional negative pressure suction (NP group). The diagnostic yield of brush cytology and liquid-based cytology were compared, with an emphasis on assessing the independent predictive value of negative pressure and CA125. Results: The application of negative pressure significantly improved the positive diagnosis rate of liquid-based cytology to 75%, compared to standard brush cytology. No significant correlations were found with the length of the biliary stricture. Multivariate analysis revealed negative pressure (OR: 5.4; 95% CI: 1.18–29; p = 0.034) and CA125 (OR: 4.80; 95% CI: 1.07–25.27; p = 0.047) as independent predictors. The predictive model achieved an AUC of 0.823, suggesting a substantial enhancement in diagnostic accuracy. Conclusions: Negative pressure suction in brush cytology presents as a superior technique for the diagnosis of biliary strictures, offering a safer and more efficacious alternative to invasive biopsy methods.