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Cáncer de páncreas

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Evidence last reviewed: 28 Sep 2026
Topic last updated: 04 Aug 2026

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • ictericia
  • malestar o dolor abdominal superior inespecífico
  • pérdida de peso y anorexia
  • dolor de espalda
Full details

Other diagnostic factors

  • dispepsia o indigestión
  • 65 a 74 años de edad
  • esteatorrea
  • sed, poliuria, nicturia y pérdida de peso
  • náuseas, vómitos y saciedad precoz
  • cambio en el ritmo intestinal
  • pancreatitis aguda inexplicable
  • hepatomegalia
  • masa abdominal epigástrica
  • signo de Courvoisier positivo
  • petequias, púrpura, hematomas
  • Signo de Trousseau (tromboflebitis migratoria)
Full details

Risk factors

  • tabaquismo
  • antecedentes familiares de cáncer de páncreas
  • síndromes de cáncer hereditario
  • pancreatitis hereditaria
  • pancreatitis crónica esporádica
  • diabetes mellitus
  • obesidad
  • factores dietarios
  • elevado consumo de alcohol
Full details

Diagnostic tests

1st tests to order

  • tomografía computarizada (TC) protocolar del páncreas
  • pruebas de función hepática (PFH)
Full details

Tests to consider

  • tiempo de protrombina (TP)
  • hemograma completo (HC)
  • biomarcador tumoral del antígeno (CA)19-9
  • Resonancia magnética (IRM)
  • tomografía por emisión de positrones
  • colangiopancreatografía retrógrada endoscópica (CPRE)
  • colangiopancreatografía por resonancia magnética
  • ultrasonido endoscópico
  • ultrasonido de abdomen
  • laparoscopia de estadificación (con ultrasonido laparoscópico)
  • biopsia
  • prueba genómica
Full details

Treatment algorithm

ACUTE

resecable (etapas 1 y 2)

localmente avanzado no resecable (estadio 3)

metastásico (etapa 4)

Contributors

Authors

Hemant M. Kocher, MBBS, MS, MD, FRCS

Professor of Liver and Pancreas Surgery

Barts Cancer Institute

Barts and The London School of Medicine and Dentistry

London

UK

Disclosures

HMK has received research grants from Bristol Myers Squibb (formerly Celgene) for investigator-initiated clinical trials. HMK has received educational grant support for attending or organising conferences from Bristol Myers Squibb, Baxalta, Mylan, Medtronic, and Oncosil, which are unrelated to this topic.

Acknowledgements

Dr Hemant M. Kocher wishes to gratefully acknowledge Dr Fieke E.M. Froeling, a previous contributor to this topic.

Disclosures

FEMF declared no competing interests.

Peer reviewers

Ross Carter, FRCS

Consultant Pancreatic Surgeon

West of Scotland Pancreatic Unit

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

Not disclosed.

Nikhil I. Khushalani, MD

Assistant Professor of Oncology

Roswell Park Cancer Institute

Buffalo, NY

Disclosures

NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma [internet publication].Full text

Conroy T, Pfeiffer P, Vilgrain V, et al. Pancreatic cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Nov;34(11):987-1002.Full text  Abstract

National Institute for Health and Care Excellence. Pancreatic cancer in adults: diagnosis and management. Feb 2018 [internet publication].Full text

Sohal DPS, Kennedy EB, Cinar P, et al. Metastatic pancreatic cancer: ASCO guideline update. J Clin Oncol. 2020 Aug 5:JCO2001364.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Cáncer de páncreas images

  • Differentials

    • Pancreatitis crónica
    • Cálculos en el conducto biliar
    • Carcinoma ampular
    More Differentials

  • Guidelines

    • NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma
    • Pancreatic cancer in adults: diagnosis and management
    More Guidelines

  • Patient information

    Cáncer de páncreas

    Cáncer de páncreas: preguntas para formularle al médico

    More Patient information
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