The diagnosis of bilio-pancreatic diseases is carried out when patients present symptoms of biliary obstruction. The majority of these patients cannot receive curative treatment at the time of the diagnosis. Laboratory tests can differentiate between intra- or extra-hepatic obstruction, and the different imaging techniques will establish the cause and degree of disease extension. Endoscopic cholangiography can confirm the tumor's etiology with a biopsy, cytology or aspiration at the level of the stenosis. Palliative endoscopic treatment offers good results. The decision of placing a plastic or metallic stent will depend on the probable survival rate that the patient has. In tumors in the hila a previous magnetic resonance cholangiography plays a fundamental role in the therapeutic decision.