**1. Introduction**

Pancreato-biliary cancers are relatively uncommon and in general, including cancers arise from the pancreas, bile duct and major ampullae. These tumours are uniformly carried a poor prognosis due to late presentation and surgical resection is only possible in less than 20% patients (David et al., 2009; Luke et al., 2009). Despites many medical advances in the imaging diagnosis, chemo-radio-therapy, surgical technique and post-operative care over the last 2 decades, the overall survival of patients with pancreato-biliary neoplasm has not improved significantly (Luke et al., 2009). The aim of the current chapter is to review and discuss current techniques and approaches to the diagnosis and management of pancreatobiliary neoplasm.
