Chronic Lymphocytic Leukemia (CLL): Spleen Surgery
When you have chronic lymphocytic leukemia (CLL), surgery is sometimes done to remove
a swollen spleen. But this is rare. This procedure is called a splenectomy. The goal
is not to cure CLL but to improve symptoms. This surgery is not used as often now
for treating CLL. This is 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 in the upper left side of the belly. It helps
fight infection and filters old, damaged blood cells out of the blood. If your spleen
is removed, your lymph nodes and liver can take over some of the spleen's functions.
But you will be at higher risk for infection.
When splenectomy is done for CLL
A splenectomy may help improve blood counts and ease pressure and discomfort caused
by 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, like your stomach. Other
treatments, such as chemotherapy or radiation therapy, are used first to try to shrink
Your spleen is filtering out 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. It can be done by making one
large cut (incision) or several smaller incisions in your abdomen (belly). The main
artery going to your spleen is tied off. The spleen is taken out. Your incision is
then closed with stitches (sutures). Talk to your healthcare provider about whether
you'll 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 can no longer help protect you against some
types of infection. Your healthcare provider will likely encourage you to get vaccines
to help prevent certain bacterial infections. Talk with your provider about this surgery
and what you can expect after it.