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.
June 14, 2018
Indications for and efﬁcacy of splenectomy for haematological disorders. Bickenbach, K. British Journal of Surgery. 2013, is 100, pp. 794-800., Sabiston Textbook of Surgery. Shelton, J. 2012, ed. 19, pp. 1548-62.
LoCicero, Richard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS