If you want to create a table in a database it is simple.
Just create a database object which points to you access .mdb file using the alias setting(so that it knows where to find your database).
Create a query (e.g. query1) and set the database name to your database.
then
if query1.active then query1.close;
query1.sql.clear;
query1.sql.add ('create table xxx (field1 type,field2 type ....)');
query1.execsql;
voila, you create you table.
If you want to open access, and perform the creation in access. I am sorry but cannot give you an answer, maybe someone else can.