Original Research

Diagnostic Yield of Brush Cytology for Biliary Strictures During ERCP

Muhammad Riaz
Arif Memorial Teaching Hospital
Sadaf Yousaf
Arif Memorial Teaching Hospital
Hafiz Muhammad Irfan
Arif Memorial Teaching Hospital
Asma Kazi
Arif Memorial Teaching Hospital
Aisha Aziz
Arif Memorial Teaching Hospital
Anjum Rashid
Arif Memorial Teaching Hospital

✉ Correspondence: Muhammad Riaz Email: doctor.riaz83@hotmail.com

DOI https://doi.org/10.70302/jpsim.v6i1.2503
Volume: 6, Issue 1 Pages: 11–15 Published: 10 Mar 2025
Received: 10 Sep 2024 Revised: 16 Jan 2025 Accepted: 24 Feb 2025 Published Online: 10 Mar 2025

Abstract

Objective

The aim of this study was to assess the yield of brush cytology in patients with biliary strictures detected at ERCP when a systematic approach is used and when a dedicated pathologist performs the cytological analysis.

Methods

A retrospective study was conducted to assess the accuracy of diagnostic brush cytology during ERCP for biliary stenosis. The study included patients with biliary strictures identified during ERCP who experienced biliary brushing cytology. We reviewed all ERCPs carried out from January, 2021 to June, 2024 in the department of Gastroenterology at Arif Memorial Teaching Hospital Lahore and Fatima Memorial Hospital Lahore. During a standard ERCP, a brush specimen was collected, and the cytology sample was promptly transferred to a glass slide by the nursing staff, who smeared the cellular material directly from brush onto the slide. The slides were then immersed in a fixative (alcohol). Subsequently, a dedicated pathologist performed the cytological analysis and categorized the samples in 3 categories: positive for malignancy, negative for malignancy, or invalid.

Results

A total of 126 patients underwent brushing for cytology in strictures seen at ERCP. There were 44 females and 82 males; 33.3% of the patients were between 45 and 65 years of age and 66.7% were older than 65 years. Overall sensitivity was 62.0% (78.0% in males and 53.0% in females).

Conclusion

Study concluded that brushing the biliary strictures for cytology is a sensitive method for the diagnosis of biliary malignancies. Using a rapid fixing technique and single dedicated pathologist reviewing the slides appears to be the reason for this high yield.

Keywords
Biliary strictures ERCP brush cytology diagnostic yield dedicated pathologist.

How to Cite This Article

Riaz M, Yousaf S, Irfan HM, Kazi A, Aziz A, Rashid A. Diagnostic Yield of Brush Cytology for Biliary Strictures During ERCP. J Pak Soc Intern Med. 2025;6(1):11–15. doi:10.70302/jpsim.v6i1.2503

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.
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