Cancers of the gallbladder and extrahepatic bile ducts are uncommon, with an estimate of 1.2 and 1.7 cancers diagnosed per 100,000 persons in the United States (1,2). As many of these tumors are unresectable at the time of diagnosis, palliative therapy is often indicated. The choice of therapy (attempt at surgical resection or palliative biliary decompression) should be based on accurate staging, with particular attention to bilateral involvement of vascular or biliary structures. The use of adjuvant chemotherapy or radiation therapy has often been employed, although there are not definitive studies that prove efficacy.