Biliary and pancreatic disease in the elderly

Cholelithiasis and its complications, along with malignancy, account for the majority of biliary and pancreatic diseases in the elderly and increase in frequency with advancing age. The presentation is often subtle and requires a high index of suspicion on the part of the clinician. Surgical management of pancreaticobiliary disease usually is associated with an increased morbidity and mortality relative to younger patients, although in some cases surgery still remains the best treatment modality. A major advance has been the development of nonsurgical therapeutic techniques, such as endoscopic sphincterotomy and biliary endoprostheses.