Gallbladder rupture following blunt abdominal trauma is a rare event recognized on evaluation and treatment of other visceral injuries during laparotomy. Isolated gallbladder rupture secondary to blunt abdominal trauma is even more uncommon. The clinical presentation of gallbladder injury is variable, resulting in a delay in diagnosis and treatment. We report the case of a patient who suffered an isolated gallbladder rupture due to blunt abdominal trauma.

Results: The study cohort included a total of 98 patients with 54 completing chemotherapy and 44 who did not. Disease free survival at 1-year was significantly improved with completing chemotherapy (HR 0.225, p < 0.01). However, this effect was no longer seen when overall disease free survival was evaluated (HR 0.901, p = 0.76). There were no measurable differences in 1-year (HR 0.997, p = 0.99) or overall survival (HR 0.993, p = 0.98) between these groups. Chemotherapy completion rates were reduced with increasing age (p < 0.01) and improved with the addition of adjuvant radiation (p < 0.01). Peri-operative complications, pancreatic fistula, length of stay, and time from resection to first chemotherapy treatment did not have a significant impact on chemotherapy completion rates. Subgroup analysis showed in patients who received adjuvant radiation, completion of chemotherapy was associated with a significantly reduced 1-year disease free survival (HR 0.100, p < 0.01). This relationship was not seen in patients who did not receive radiation (HR 0.35, p = 0.11). Conclusion: Completion of adjuvant chemotherapy in patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma appears to have a disease-free survival benefit within the first year, but its effect is lost beyond this point. Despite incomplete treatment, overall and 1-year survival did not appear to be adversely affected. These Results suggest that complete and partial adjuvant chemotherapy have similar long-term benefits. Patients who received radiation therapy had a higher rate of completion of their planned chemotherapy regimen, possibly secondary to the break from the chemotherapy agents while receiving radiation.