A STUDY OF THE EFFECT OF AGE ON PANCREATIC DUCT MORPHOLOGY

Background: Interpretation of endoscopic pancreatograms is difficult i n elderly patients. Age-related parenchymal changes and associated duc tographic changes are ill-defined, and it is sometimes difficult to di stinguish these from pathologic processes. Methods: To define age-rela ted pancreatogram changes, all endoscopic retrograde pancreatograms pe rformed in patients older than 70 years of age over a g-year period we re analyzed and compared with those of a control group (younger than 5 0 years of age). Results: Of the 136 elderly subjects included in the study, 31 (22.8%) were found to have definite pathology. Comparing the remaining 105 subjects with the control group, the mean main pancreat ic duct diameter tin millimeters) was larger in the head (5.3 vs. 3.3) , body (3.7 vs. 2.3), and tail (2.6 vs. 1.6) (p < 0.05). The duct diam eter also increased significantly in each of the age cohorts (70 to 79 , 80 to 89, and 90 to 99 years). Only 33 of 105 (31.4%) of the elderly patients had duct diameters within defined normal limits. In the majo rity (63.3%), dilatation was global but in a minority it was confined to the head and/or body. In 21 subjects the ductal diameter was greate r than 2 standard deviations above normal, and in 5 subjects it was gr eater than 3 standard deviations above normal. Dilatation of secondary ducts was also observed. Conclusion: The majority of elderly patients who do not have pancreatic pathology have a dilated pancreatic duct b y comparison with younger patients. Patient age must be considered whe n interpreting endoscopic pancreatograms.