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Backgaround and Aims:Endoscopic retrograde cholangio pancreatogaphy guided bile duct cytology for the diagnosis of indeterminate bile duct strictures is commonly used. The aim of this study was to define sensitivity, specificity, and positive and negative predictive values of endoscopic retrograde cholangio pancreatogaphy brush cytology from indeterminate biliary strictures. Materials and Methods:We retrospectively analyzed diagnostic yield of brush cytology in indeterminate biliary strictures in our single center, between January 2013 and April 2014. Demographic data, endoscopic retrograde cholangio pancreatogaphy reports, pathology reports, post-endoscopic retrograde cholangio pancreatogaphy operation, percutaneous biopsy results, the course of the disease and survival of the patientswere recorded. Results:Cytologic examination of thirty seven samples were done in 35 patients. The mean age of patients was 63.7±12 years. There were 19 females and 16 males. Three patients had adenocarcinoma, one high grade dysplasia and one low grade dysplasia, which were detected at cytological evaluation. Twenty samples were reported as normal with sufficient material; 3 were reported as insufficient material; and 9 were reported as indeterminate. The diagnosis of malignancy was confirmed with other methods in 4 patients. Follow-up data was obtained in 13 of 18 malignancy negative patients. Ten of the 13 patients were detected negative for malignancy and 3 were diagnosed malignant with additional examinations. Also, 3 out of 12 patients whose cytological results were insufficient or indeterminate were diagnosed malignant after additional examinations; the remaining 9 patients were found negative for malignancy. In accuracy analysis, the sensitivity of brush cytology was calculated as 57.1%, specificity 100%, positive predictive value 100% and negative predictive value 76.9%. Conclusion:In cases with indeterminate biliary strictures, positive predictive value of brush cytology was high but negative cytology results do not exclude malignancy. Cases with high suspicion of malignancy must be evaluated with additional examinations

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