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INTRODUCTION Surgery alone shows an insufficient result for distal cholangiocarcinoma, and postoperative adjuvant chemotherapy is commonly used. However, no definite opinion has yet been accepted. SUBJECTS AND METHODS A group of 46 patients who underwent surgery for distal bile duct cancer and who received adjuvant chemotherapy including gemcitabine (GEM)(Group A)and surgery alone group(Group S)were compared for disease-free survival(DFS)and overall survival (OS). RESULTS Although the median DFS was 718 days in Group A and 367 days in G