Pancreatic cancer mainly refers to pancreatic exocrine ductal adenocarcinoma: it is the most common type of pancreatic malignant tumor, accounting for about 1% to 4% of all kinds of cancers in the body and 8% to 10% of malignant tumors of the digestive tract. Pancreatic cancer is insidious, fast progressing and highly malignant. Because of the special anatomical location, early symptoms are not obvious and specificity is poor, so it is difficult to be detected early clinically. As the elderly age, they may have cognitive dysfunction and decreased sensitivity to pain. There may also be a variety of high-risk factors, such as smoking, alcohol consumption, diabetes, obesity, chronic pancreatitis, biliary tract disease or history of biliary tract surgery, which make the symptoms of pancreatic cancer more atypical and lead to missed diagnosis or misdiagnosis. Lack of typical clinical manifestations in the early stage of pancreatic cancer: most of the patients are already in the late stage when the diagnosis is clear, and only a few of them can be resected, accounting for 10%-15%, with poor treatment effect. The median survival period for those who can undergo surgical resection with or without adjuvant chemotherapy is 11-23 months, and the 5-year survival rate is less than 20%. The median survival is 6-10 months for 10-15% of those with local progression and no distant metastases at initial diagnosis. Patients with pancreatic cancer with metastasis have a survival period of 3-6 months. The early symptoms of pancreatic cancer include three prominent ones: (1) anorexia, indigestion and weight loss; (2) abdominal discomfort or pain, about half of the patients have abdominal pain as the first symptom, about 20% of the patients have abdominal pain radiating to the back and left shoulder, the pain increases when lying on the back and decreases when sitting or standing, bending, lying on the side or bending the knees; (3) jaundice, manifested as yellowing of the skin and sclera. There is less literature on whether elderly patients, especially those aged 70 and above, need active treatment and the impact of various treatments on their survival. In recent years, our hospital has vigorously carried out surgical treatment of pancreatic cancer and accumulated a lot of experience in the comprehensive perioperative treatment of elderly patients with pancreatic cancer, many of whom were very old, aged 88-91, and all of them successfully underwent surgery and were discharged from the hospital, including pancreaticoduodenectomy and caudal resection of the pancreatic body. In addition, obstructive jaundice and the trauma of the surgery itself increase the risk of various complications in the perioperative period, mainly cardiopulmonary insufficiency, leading to a passive delay in the removal of the postoperative tracheal tube, which in turn increases the chance of pulmonary infection, especially in the case of surgical site complications, which can worsen the already existing non-surgical site complications. The latter increases the chance of pulmonary infection, especially in the presence of surgical site complications, and can worsen existing non-surgical site comorbidity. This places a higher demand on postoperative intensive care. Older patients are more likely to have delayed gastric emptying after pancreaticoduodenectomy, which is associated with psychiatric and gastric vagus nerve injury, destruction of local gastric structures, anemia, malnutrition, severe abdominal infection, and prolonged anastomotic reconstruction. Nutritional support is an extremely important measure in the treatment of delayed gastric emptying. The route of nutritional therapy (enteral nutrition or parenteral nutrition) is chosen according to the condition. If the patient has good intestinal function, enteral nutrition is preferred. The infusion speed, concentration and supply amount should be adjusted gradually from low to high, and the insufficient part can be supplemented by parenteral nutrition, and finally transition to total enteral nutrition. For elderly patients with pancreatic cancer, any single treatment may not necessarily achieve better efficacy, so individualized treatment plan should be formulated according to the physiological and pathological characteristics of the elderly. For elderly patients with early-stage pancreatic cancer in good physical condition, radical surgical resection is the main treatment, while for elderly patients with intermediate and advanced stages that cannot be surgically resected, a comprehensive treatment system of chemotherapy, radiotherapy and intervention can be considered in order to maximize the long-term survival rate and quality of life. For patients with good postoperative recovery and inoperable advanced patients, we advocate individualized combined radiotherapy and chemotherapy treatment. Although studies have shown that treatment with chemotherapy for pancreatic cancer prolongs overall patient survival, there is no clear evidence whether aggressive treatment should be adopted for patients of advanced age. We treat elderly pancreatic cancer patients with the classic combination of gemcitabine and/or tegeo, supplemented with low-dose radiotherapy in some patients, which is well tolerated by patients and is effective in controlling tumor, reducing recurrence, and prolonging survival. For patients who are physically assessed to be unable to tolerate the combination therapy, we give tegeo single agent oral therapy, which is tolerated by most elderly patients, with significant improvement in functional status and improved quality of life. Since pancreatic tumors have no specific manifestations during growth, and there is no effective screening method or reliable diagnostic test for pancreatic cancer, early diagnosis is quite difficult. To improve the detection rate of early pancreatic cancer, we must pay attention to the surveillance of high-risk groups. For example, regular abdominal ultrasound or CT examination, combined testing of multiple tumor markers, especially for the elderly. Clinically, for elderly people of advanced age, they should be alert to the alarming symptoms of pancreatic cancer, such as: upper abdominal discomfort, loss of appetite, weight loss, and the presence of high-risk factors, etc. They should be examined in time to detect early cases, which can significantly improve the prognosis of pancreatic cancer.