The value of endoscopic study of the bile ducts and the pancreas in the elderly.

Endoscopic retrograde cholangiopancreatography was performed in 46 patients age 60 or older with various suspected pancreaticobiliary or duodenal diseases. Thirty-one patients (67.4%) had diagnostically satisfactory opacification of a duct system. Pathologic conditions obstruction injection of the contrast medium prevented opacification in eight patients (17.4%). Seven cannulations (15.2%) were technical failures. There was one complication, a Gram-negative septicemia that was successfully treated. The procedure is of value in the geriatric patient because it may provide preoperative evidence of pancreatic or biliary disease that cannot be diagnosed by any other technique. In jaundiced patients, identification of the site of obstruction facilites the surgical approach and thus reduces operating time. If the common bile duct is shown to be patent, the patient is spared exploratory surgery or a prolonged hospital stay for observation. Although a normal pancreatic duct does not exclude cancer of the pancreas, it should influence the physician to search for other explanations for abdomianl pain or weight loss befror proceeding with abdominal surgery.