Splenectomy (surgical removal of the spleen) is sometimes required in elective and emergent surgery. For patients with pancreatic cancer, the spleen often is removed with your cancer. Good news is that you can live and have a meaningful life without your spleen.
Where is the spleen?
The spleen is located on your left side under your ribs. You cannot feel your spleen. It is near your stomach, pancreas, and colon. It is about the size of your fist.
What does the spleen do?
The spleen is important in filtering the blood and removing old red blood cells. It helps in fighting infection and stores white (monocytes) and red blood cells. The spleen can produce antibodies and help recycle iron.
What is a splenectomy?
Splenectomy is the surgical removal of the spleen. Sometimes the spleen is removed after it is injured during a car accident. This is considered an emergent splenectomy. The spleen can be involved with cancers of the stomach, pancreas, and colon and also require removal.
What is the risk of not having your spleen?
Infection is a major concern after splenectomy. Overwhelming post-splenectomy infection (OPSI) is a rare but potentially life-threatening infection caused by encapsulated organisms, such as strep. The yearly risk of such infection is less than 1% after splenectomy. OPSI can be treated with antibiotics and risk reduced with up-to-date vaccinations.
Vaccinations
All patients who have their spleen removed should have vaccinations. The specific vaccinations and timing of vaccinations should be discussed with your physician. In general, we recommend the following:
- Influenza vaccine each year to protect against seasonal flu
- Tdap vaccine to protect against whooping cough and tetanus
- Hib vaccine to protect against Haemophilus influenzae type b (Hib) if you were not previously vaccinated with the vaccine
- Pneumococcal vaccines (both types) to protect against pneumonia and other pneumococcal disease
- Meningococcal vaccines (both types) to protect against meningitis and other meningococcal disease
Other vaccines are recommended but not necessarily due to not having a spleen. For more guidelines regarding vaccinations after splenectomy see the Centers for Disease Control website for very detailed information.