Chronic Lymphocytic Leukemia (CLL): Surgery
With chronic lymphocytic leukemia (CLL), surgery is sometimes used to remove a swollen
spleen. This procedure is called a splenectomy. The goal is not to cure CLL, but to
improve symptoms. It's rarely needed today because other treatments work well to control
CLL and keep the spleen from swelling.
What is the spleen?
The spleen is an organ near the stomach. It’s part of the system that makes white
blood cells and destroys old red blood cells. It also helps to prevent infections
by filtering bacteria in the blood.
When splenectomy is done for CLL
A splenectomy may help improve blood counts and relieve pressure and discomfort from
an enlarged spleen. Your healthcare provider may suggest that you have a splenectomy
if you have one or both of these problems:
Your spleen is so swollen that it's pushing on other organs, such as your stomach.
Other treatments, such as chemotherapy or radiation therapy, are used first to try
to shrink the spleen.
Your spleen is removing too many red blood cells and platelets from your blood. It's
your spleen's job to remove worn-out blood cells. But leukemia can make your spleen
overactive. A splenectomy can help raise your red blood cell and platelet counts.
Vaccines before your surgery
You may need some vaccines before surgery. This is because your risk for certain infections
will increase after your spleen is removed.
What to expect for your surgery
A surgeon does a splenectomy in a hospital. The surgery will take from 90 minutes
to 3 hours. It depends on the way the surgery is done. The surgery is done by making 1
large cut (incision) or several smaller incisions in your abdomen. The main artery
going to your spleen is tied off. The spleen is removed. Your incision is then closed
with stitches (sutures). Talk to your healthcare provider about whether or not you
will need to stay in the hospital after surgery.
Preventing infections after a splenectomy
You'll need to be careful to avoid infection after your surgery and for the rest of
your life. That's because your spleen helps protect you against some types of infection.
Your healthcare provider will likely encourage you to get vaccines to help prevent
certain bacterial infections. He or she will give you more information.