[Therapy of pancreatitis and excretory pancreatic insufficiency in elderly patients]

Early active conservative therapy is of decisive importance for the prognosis of acute pancreatitis. Irrespective of the age of the patient a standardized basic therapy has to be adopted, but even in the old patient elective surgical treatment should not be regarded as "ultima ratio". As a matter of principle, conservative measures should first be taken to treat chronic pancreatitis. Surgery will be indicated in the presence of resistance of therapy or complications irrespective of the patient's age. Insufficiency of the excretory pancreatic function in old age may be asymptomatic, whereas gastrointestinal complaints can be improved or eliminated by enzyme substitution. But if the gastrointestinal symptoms complex in the elderly cannot be influenced by the administration of pancreatic enzyme, it would not be serious to dismiss such symptoms as consequences of the process of ageing.