In order to evaluate the operative possibilities in patients with obstructive carcinoma of the biliary tract a precise diagnosis of local extent of the tumor and metastasis is essential (cholangiography, US, CTscan). The treatment is preferably surgical whether the tumor be resectable or not. However some patients who, for any reason, are not surgical candidates can be helped by new endoscopic intubation techniques. Medical and surgical consultation is essential to set the criteria for the best treatment modality in all patients with this disease, especially those who are not surgical candidates.