PURPOSE: Patients with gallbladder cancer tend to have advanced, unresectable tumor at the time of presentation and they face a dismal prognosis in the absence of a standard chemotherapy regimen. This study was performed to evaluate the outcomes of patients with gallbladder cancer and who underwent postoperative gemcitabine-based chemotherapy. METHODS: From March of 2001 to February of 2008, a total of 27 patients underwent operation for gallbladder cancer. They underwent two types of gemcitabine-based chemotherapy. One type of regimen was the combined administration of gemcitabine 1,000 mg/m2 and 5-fluorouracil 200 mg/m2. The other one was combined administration of gemcitabine 1,000 mg/m2 and cisplatin 70 mg/m2. RESULTS: Among the 27 patients, 15 patients were treated with gemcitabine-based chemotherapy and 12 patients were treated with many kinds of the best supportive care without chemotherapy. The median survival was 29.1+/-2.7 months and 15.7+/-2.8 months, respectively. The median survival and disease free survival for the gemcitabine based chemotherapy group who received curative resection was 31.6+/-2.5 and 15.7+/-3.2 months, respectively. The median survival and disease free survival for the patients without chemotherapy after curative resection was 16.3+/-2.9 and 15.7+/-3.2 months, respectively. CONCLUSION: Patients with gallbladder cancer and who received adjuvant gemcitabine-based chemotherapy had a relatively favorable prognosis. Especially, gemcitabine-based combination chemotherapy could be effective and acceptable for the treatment of gallbladder cancer patients who have undergone curative resection.