Benign Disease of the Gallbladder and Pancreas in the Elderly

Benign disorders of both the gallbladder and pancreas are important diseases to account for within the elderly population. The incidence of cholelithiasis increases with age, and acute cholecystitis is a common presentation in the elderly. Pancreatic disease including pancreatitis, most likely due to gallstones, is less common in the elderly, compared to the general population. Elderly patients are more likely to present with nonspecific, constitutional symptoms often leading to a delay in diagnosis. However, many of the diagnostic modalities and treatment algorithms essentially remain the same as endoscopic, percutaneous, and surgical interventions are safe and feasible in the elderly population. The higher risk of morbidity and mortality with biliary or pancreatic disease is due to decreased reserve and exacerbation of comorbidities making it critical to identify and optimize the comorbidities of these patients. A multidisciplinary team approach to a focused comprehensive geriatric assessment in the perioperative period helps identify risk factors and informs postoperative management, with improved outcomes.