Abstract: Objective To compare the clinical effects of two blood purification modalities, dual filtration plasma exchange and plasma adsorption, in the treatment of hyperlipidemic acute pancreatitis (HTG-AP).  Methods  Clinical data of the 75 HTG-AP patients admitted to Sanya People's Hospital or Jilin People's Hospital from May 2021 to April 2023 were retrospectively studied. There were 24 cases in the double filtration plasmapheresis (DFPP) group, 26 cases in the plasma adsorption (PA) group, and 25 cases in the conventional treatment group. Biochemical indexes, fasting time, abdominal pain relief rate after 72h, complications, hospitalization expenses and recurrence rate were compared among the three groups after the treatment.  Results Serum triacylglycerol, cholesterol, hs-CRP and interleukin 6 (IL-6) decreased more in the DFPP group within 24h after the treatment than in the conventional treatment group (t=8.136, 4.577, 3.671 and 2.241 respectively; P＜0.001, ＜0.001, =0.001 and =0.030 respectively). Serum triacylglycerol, cholesterol, hs-CRP, serum amyloid A (SAA) and IL-6 decreased more in the PA group than in the conventional treatment group  (t=10.533, 4.679, 3.347, 3.622 and 2.356 respectively; P＜0.001, ＜0.001, =0.002, =0.001 and =0.023 respectively). However, there were no statistical differences in these biochemical indexes between the DFPP group and the PA group (P＞0.05). The recurrence rate had statistical difference between the DFPP group and the conventional group (χ2=6.050, P=0.049). There were no statistical differences in total hospitalization expenses among the three groups (F=1.787, P=0.175).  Conclusion  DFPP and PA are two blood purification treatment modalities that can rapidly and effectively reduce serum lipids. They are beneficial to block  inflammatory responses, reduce the chance to develop serious illnesses, and obtain better clinical efficacies.

Key words: Hyperlipidemic acute pancreatitis, Double filtration plasma exchange, Plasma adsorption