Objective:To discuss the diagnosis and treatment of acute pancreatitis in elderly patients.
Methods:The data of 254 consecutive elderly patients with acute pancreatitis treated in our hospital in recent 5 years were analysed, retrospectively, and compared with another 258 non-elderly patients with acute pancreatitis (control group).
Results:Among the elderly patients（≥60 years old） with acute pancreatitis, 112 of them were male and 142 were female. In elderly group, 218 cases had mild acute pancreatitis (MAP), 2 of whom died; and 36 cases had severe acute pancreatitis (SAP), 13 of whom died. There was a positive relationship between mortality and age （P＜0.01）.The rate of the acute pancreatitis caused by biliary diseases was 70.9%. Compared to control group, in the elderly group the levels of blood amylase （1 054.97±775.60）U/L and serum total bilirubin (40.97±37.11) μmol/L were much higher （P＜0.05）; and the diagnostic rate of CT（68.9%） was obviously higher than that of ultrasound（22.8%）（P＜0.01）. Surgical treatment was applied to 65 elderly patients, and 46 of them underwent endoscopic treatment.  In elderly group, 35 patients(13.8%) suffered various complications; but only 20 patients (78%) had complications in control group（P＜0.05）. 
Conclusions:The cause of acute pancreatitis  in elderly patients is usually related to biliary factors. Marked elevation of blood amylase and serum total bilirubin is significant in these patients, and they have more complications and a high mortality. CT should be the first method used for the diagnosis of acute pancreatitis in the elderly, and combined therapeutic measures should be employed.  ERCP can be indicated for the elderly patients with acute pancreatitis caused by  obstruction and infection of bile duct. Mortality of acute pancreatitis in the elderly is high and it increases with increasing age of the patient.