Inclusion Criteria:

- Patients must have biopsy-proven, resected with curative intent cholangiocarcinoma,
gallbladder, pancreatic or ampullary adenocarcinoma.

- Patients must be 18 years or older.

- Patients must have a NCI CTC Performance Status of 0-2.

- Patients must not have any prior chemotherapy or radiation therapy for this current
malignancy.

- At least 3 weeks should have elapsed since any surgery requiring general anesthesia.

- Patients must have no prior malignancies except for basal or squamous skin cancers,
cervical carcinoma-in-situ, unless in remission for >5years

- Pregnant patients are not eligible. Non-pregnant status will be determined in all
women of childbearing potential. All patients will be required to use an effective
means of contraception if sexually active during therapy.

- Initial Required Laboratory Values:

- Absolute neutrophil count ≥ 1,500/mm3, platelet count ≥ 150, 000/mm3, and hemoglobin
≥ 9 g/dL.

- Serum creatinine should be ≤ 2 mg/dL.

- Serum bilirubin should be ≤ 3.0 mg/dL (biliary stents allowed).

- Serum transaminases should be ≤ 5-fold the institutional upper limits.

- Patients must not have any co-existing severe medical illnesses, such as unstable
angina, uncontrolled diabetes mellitus, uncontrolled arrhythmia or uncontrolled
infection.

- Patients must be able to sign an informed consent.

Exclusion Criteria:

- None