{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:32:35Z","timestamp":1793147555257,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Aspiration pneumonia is a well-described complication of upper digestive endoscopy. However, limited data are available on incidence, risk factors and clinical consequences of post-endoscopic retrograde cholangiopancreatography (ERCP) aspiration pneumonia (pEP). Materials and Methods: All consecutive ERCPs performed under anesthesiologist-administered sedation at the Endoscopy Unit of the University of Verona between 1 April 2022 and 31 August 2024 were retrospectively evaluated. Demographic, clinical and endoscopic data were collected. Results: One thousand one hundred forty consecutive ERCPs were included. The main indication was malignant biliary stricture, and the patient\u2019s mean age was 68 \u00b1 13.9 years. Overall incidence of pEP was 2.7%. The American Society of Anesthesiologists (ASA) score, presence of active cholangitis before ERCP and performance of endoscopic ultrasound (EUS) and ERCP in the same sedation session were significantly associated with a higher risk of pEP at both univariable and multivariable analysis. pEP was an independent risk factor for post-ERCP 30-day mortality and for prolonged hospital stay. Conclusions: pEP is a relatively frequent adverse event after ERCP. In patients with a high ASA-score, active cholangitis and scheduled EUS and ERCP in the same sedation session, preventive medical and\/or anesthesiological strategies might be considered. Additional prospective studies are needed to confirm these data.<\/jats:p>","DOI":"10.3390\/medicina61122172","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"2172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Aspiration Pneumonia After ERCP Under Anesthesiologist-Administered Sedation: Prevalence, Risk Factors and Clinical Outcomes of an Underestimated Adverse Event"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-681X","authenticated-orcid":false,"given":"Nicol\u00f2","family":"de Pretis","sequence":"first","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Calderini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Maria","family":"Mora","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Cerioli","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Galli","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-1583","authenticated-orcid":false,"given":"Maria Cristina","family":"Conti Bellocchi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Gabbrielli","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Trento, 38122 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7053-8434","authenticated-orcid":false,"given":"Katia","family":"Donadello","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Gynaecology and Paediatrics, University of Verona, 37124 Verona, Italy"},{"name":"Anesthesia and Intensive Care Unit B, University Hospital Integrated Trust of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Brazzo","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit B, University Hospital Integrated Trust of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0472-1609","authenticated-orcid":false,"given":"Luigi","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Azienda Provinciale Servizi Sanitari, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4256-9953","authenticated-orcid":false,"given":"William","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Azienda Provinciale Servizi Sanitari, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-2655","authenticated-orcid":false,"given":"Luca","family":"Frulloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4560-8741","authenticated-orcid":false,"given":"Stefano Francesco","family":"Crin\u00f2","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1111\/j.1572-0241.2007.01279.x","article-title":"Incidence rates of post-ERCP complications: A systematic survey of prospective studies","volume":"102","author":"Andriulli","year":"2007","journal-title":"Am. 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