Surgery for CLL

With chronic lymphocytic leukemia (CLL), surgery is sometimes used to remove a swollen spleen, a procedure called a splenectomy. Your spleen is an organ near your stomach that's involved in the production of white blood cells and destruction of red blood cells. It also helps in preventing infections by filtering bacteria in the blood. A splenectomy does not cure CLL, but may help improve blood counts and relieve pressure and discomfort from an enlarged spleen.

Your doctor may recommend that you have a splenectomy if you have CLL and have 1 or both of these problems:

  • Your spleen has become so swollen from leukemia that it's compressing other organs, such as your stomach. (Usually other treatments, such as chemotherapy or radiation therapy, are used first to try to shrink the spleen before using surgery.) 

  • Your spleen is removing too many red blood cells and platelets from circulation. It's your spleen's job to remove worn-out blood cells, but the leukemia can make your spleen overactive. A splenectomy can help raise your red blood cell and platelet counts.

Because your risk for infections increases after surgery, you may need to have some vaccinations before surgery.

What happens during surgery for CLL

A surgeon performs a splenectomy in a hospital. Before your surgery, your doctor will make sure that any infections you have are cleared up and that you have received any needed immunizations. You will check into the hospital the day before your surgery or early on the day of the procedure. You'll meet with your surgeon and an anesthesiologist, the doctor who will handle your anesthesia.

The surgery itself will take from 90 minutes to 3 hours, depending on the way the surgery is done. Overall, the procedure involves making 1 large incision (cut) or several smaller incisions in your abdomen, tying off the main artery going to your spleen, and removing the spleen. Your incision is then closed with sutures (stitches).

What to expect after surgery

You will probably remain in the hospital for less than a week after your surgery. During this time, and after you leave the hospital, you'll need to be careful to avoid infection. In fact, you'll need to be careful about infections for the rest of your life. That's because your spleen is an organ that helps protect you against infection. Your doctor will probably recommend that you get vaccines to help prevent certain bacterial infections.