Upper gastrointestinal obstruction occurs in patients with pancreatic cancer. Patients with tumors evaluated as unresectable can obtain palliative relief by endoscopic placement of an intestinal stent, especially when the expected survival is short and the general condition is poor. Another commonly used approach is percutaneous endoscopic gastrostomy catheter placement (PEG). Laparoscopic gastrojejunostomy may also be considered for patients with an expected survival of >3-6 months. For patients evaluated for possible resection and found unresectable by open surgery, gastrojejunostomy should be performed even in the absence of symptoms.