Dual stenting was found to be more feasible and efficient in palliation of advanced head of pancreas cancer with short procedure time and short hospital stay and less morbidity and mortality and ICU admission with higher cost in comparison with surgical bypass. Surgical bypass is mandatory in patient with gastric outlet obstruction or failed Endoscopic Retrograde Cholangiopancreatography (ERCP) trial due to huge mass obstructing the duodenum.