For therapy of malignant jaundice different methods are possible: The palliative operative bypass and the monoperative stent implantation by endoscopic or transhepatic procedure. The primary success rate of both methods is similarly high (> 90%). The rate of early complication and the lethality of the stent implantation compared to the operative procedure are lower. The rate of occlusion and incidence of later cholangitis by operative bypass are lower. Postoperative lethality is related to the ASA classification. The preoperative diagnosis of resectability by CT, NMR, angiography and diagnostic laparoscopy has a success rate of maximally 95%. The choice of therapeutic method is therefore related to the general condition of the patient (ASA, staging, duodenal stenosis, expected survival time).