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Keeping the spleen during cancer surgery | CION Cancer Clinics
Spleen-preserving surgery keeps all or part of the spleen during an operation where it might otherwise be removed. It is considered for some low-grade pancreas tumours, small growths at one end of the spleen, and surgery in children. It is usually not possible when cancer involves the spleen or the glands around its blood vessels. Here is how surgeons decide, and what to ask before your operation. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Can the spleen be kept during cancer surgery?
- In which situations is the spleen sometimes kept?
- How does the surgeon decide during the operation?
- What do the words on the operation note mean?
- What do people assume about keeping the spleen?
- Who is spleen-preserving surgery not suitable for?
- Common questions about keeping the spleen
The short answer
Can the spleen be kept during cancer surgery?
Sometimes, yes. When the disease does not involve the spleen or the glands around its blood vessels, a surgeon may remove only part of the spleen, or leave it entirely in place while taking out a nearby organ. When cancer sits in or right beside the spleen, the whole spleen usually has to come out.
Two different things go by this name
A partial splenectomy removes one section of the spleen and leaves the rest working. It is uncommon in cancer care, and is used mainly for a small growth or cyst limited to one end. Spleen-preserving surgery more often means something else: an operation on the tail of the pancreas, or sometimes the stomach, where the spleen would traditionally be removed too, but the surgeon keeps it.
Why keeping it is worth trying
The spleen filters the blood and helps fight certain germs, especially those that cause pneumonia and meningitis. People without a spleen carry a small but lifelong risk of a sudden, serious infection. Keeping even part of it may lower that risk. How much protection a partly kept spleen gives is still being studied, so vaccines are often advised anyway.
Whether the spleen can be kept is a decision for your surgical team. Sometimes it is only settled during the operation itself.Where it applies
In which situations is the spleen sometimes kept?
These are the situations where surgeons most often consider it. Being in one of them does not mean it will be possible for you.
Low-grade tumours in the pancreas tail
Some slow-growing tumours of the pancreas, such as certain neuroendocrine tumours or cysts, can be removed with the spleen left behind. The glands near the spleen matter less for these.
A small growth at one end of the spleen
A cyst or a small, non-cancerous lump confined to one pole of the spleen may be removed with a partial splenectomy.
Injury to the spleen during surgery
If the spleen is nicked while operating nearby, surgeons usually try to repair it rather than remove it, provided the bleeding can be controlled.
Children and young adults
Because infection risk without a spleen is higher in young children, surgeons are more likely to try to keep spleen tissue when it is safe.
Teams will weigh
- The type of tumour
- Whether nearby glands need removing
Not sure whether this applies to you?
Ask an oncologistIn the operating theatre
How does the surgeon decide during the operation?
The plan starts from the scans
CT or MRI pictures show how close the tumour is to the spleen and its blood vessels. If the vessels run into the tumour, keeping the spleen is usually not realistic.
The consent covers both outcomes
You will usually be asked to agree to full removal if keeping the spleen turns out to be unsafe. Ask how likely that is in your case.
The blood supply is checked
The spleen needs enough blood flow to survive. The surgeon either keeps its main vessels or relies on the smaller ones from the stomach, and checks the colour of the spleen before closing.
Bleeding decides the rest
If bleeding from the spleen cannot be stopped safely, the whole spleen is removed. Your team will tell you afterwards what was done.
On your report
What do the words on the operation note mean?
- Partial splenectomy
- Removal of one section of the spleen, with the rest left in place and working.
- Spleen-preserving distal pancreatectomy
- Removal of the tail and sometimes the body of the pancreas, with the spleen kept. The pancreas tail lies right against the spleen.
- Splenic hilum
- The spot where the main blood vessels enter the spleen. Disease here usually means the spleen cannot be kept.
- Lymph node
- A small gland that filters fluid and can trap cancer cells. Some cancers need the glands near the spleen removed along with it.
- Accessory spleen
- A small extra piece of spleen tissue some people are born with. It may be mentioned on a scan and is usually harmless.
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Did you know
The tail of the pancreas lies so close to the spleen that the two share blood vessels. That closeness is why the spleen was, for a long time, removed as a matter of routine in pancreas tail surgery.
Commonly believed
What do people assume about keeping the spleen?
"Keeping the spleen is always the safer choice."
Not when cancer may have reached the spleen or the glands beside it. Leaving that tissue behind could leave disease behind. For those cancers, removing the spleen is part of doing the operation properly.
"If they kept part of it, I do not need vaccines."
A partly kept spleen may work less well than a whole one, and the evidence on how much it protects is limited. Many teams still recommend vaccines. Ask your doctor what they advise for your situation.
"The surgeon removed it because they were in a hurry."
When the spleen bleeds and the bleeding cannot be stopped, removing it is the safe decision. The operation note should explain why. You can ask the surgeon to go through it with you.
"We should look for a centre that always keeps the spleen."
No surgeon can promise it in advance, because the decision often depends on what is found during the operation. Ask any centre how they decide, not whether they always do it.
Being straight with you
Who is spleen-preserving surgery not suitable for?
It is usually not suitable when the cancer needs the spleen or its nearby glands removed. That includes most adenocarcinomas of the tail of the pancreas, which is the common type of pancreatic cancer, and some stomach cancers near the spleen. It is also not used when the spleen is the problem itself, as in blood cancers that make it swell hugely.
What this page cannot tell you
It cannot tell you whether your spleen can be kept. That depends on the type and position of the tumour, what the scans show around the blood vessels, and what the surgeon finds on the day. A plan made before surgery can change once the tummy is open, for sound reasons.
What to ask before the operation
Ask whether keeping the spleen is being considered, and why or why not. Ask what would make the surgeon remove it after all. Ask whether you should have your vaccines before surgery just in case, because vaccines work better when given before a planned splenectomy. Bring the family member who will help you remember the answers.
Ask your centre directly whether they perform partial splenectomy or spleen-preserving pancreas surgery, and how often.Questions we are asked
Common questions about keeping the spleen
Does a partly kept spleen still work?
It often keeps some of its filtering and infection-fighting work, provided it has a good blood supply. How much protection it gives is not fully known, because the studies so far are small. That is why many doctors still advise vaccines and ask you to take any fever seriously.
Will I know before surgery whether the spleen will be kept?
You will know what is planned, but not always the final outcome. The surgeon may aim to keep it and then find the tumour is too close, or bleeding cannot be controlled. Ask your team to explain both possibilities, and what each would mean for you afterwards.
Is keeping the spleen possible with keyhole surgery?
It can be. Some surgeons perform spleen-preserving pancreas surgery by keyhole, and others prefer an open operation. It depends on the tumour and the surgeon's experience. Ask your centre which approach they use for this operation, and why that one suits your scans.
Do I need vaccines if my spleen was kept?
Your doctor will advise you. Many teams recommend vaccines before any operation where the spleen might be removed, in case it has to come out. If it was kept whole and works normally, the advice may be different. Ask before discharge, and write down what you are told.
Does keeping the spleen make the operation riskier?
It can make the operation longer and more delicate, because the surgeon has to protect small blood vessels. There can be a risk of the kept spleen losing its blood supply afterwards. Your surgeon will explain the specific risks that apply to your operation before you sign the consent form.
Can a spleen be kept in pancreatic cancer?
For the common type of pancreatic cancer in the tail of the pancreas, the spleen is usually removed with the glands around it. For some slower-growing tumours of the pancreas, keeping it may be possible. Your biopsy report and scans help the team decide which situation applies.
What happens to the part of the spleen that is removed?
It goes to the laboratory with the rest of the tissue taken out. The pathologist checks it under the microscope and writes a report. Your surgeon will go through that report with you at a follow-up visit, including whether any disease was found in the spleen.
Will I need follow-up scans for the kept spleen?
Sometimes. A scan may be done to check the kept spleen has a good blood supply, especially if you have pain on the left side or a fever afterwards. Most follow-up scans are really checking on the cancer itself. Your team will tell you what is planned and when.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- NHS — Spleen problems and spleen removal
- National Cancer Institute — Splenectomy (NCI Dictionary of Cancer Terms)
- Cancer Research UK — Pancreatic cancer
- Macmillan Cancer Support — Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why the Spleen Is Removed in CancerThe cancers where full removal is part of the operationCan You Live Without a Spleen?What changes if the spleen cannot be keptVaccinations Before and After SplenectomyWhy vaccines are often given before surgery just in caseDeciding on Cancer SurgeryHow to weigh a surgical plan with your team
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