Abstract: 【Abstract】Objective To observe the effect of plasma exchange (PE) at early disease stage on clinical outcome of the patients with non-mild hypertriglyceridemic pancreatitis (HTGP). Methods A total of 67 non-mild HTGP patients treated in the ICU of our hospital from August 2013 to August 2019 were recruited. The patients were divided into early PE group (PE after abdominal pain for <48hours; n=33) and late PE group (PE after abdominal pain for >48hours; n=34). Clinical data of the patients were collected. The main outcomes including in-hospital mortality, organ failure, intra-abdominal hypertension (IAH), acute peri-pancreatic fluid accumulation, acute pancreatic necrosis, pancreatic pseudocyst, infected pancreatic necrosis, and surgical intervention were recorded during hospitalization. The period of staying in ICU, total length of staying in hospital and medical expenses were calculated. Results were analyzed using SPSS 19.0 statistical software. Results Compared to the patients in late PE group, patients in early PE group had lower rates of acute pancreatic necrosis, pancreatic pseudocyst, surgical interventions, transient organ failure, persistent respiratory failure and persistent renal failure (χ2＝7.923, 7.403, 5.518, 4.377, 4.750 and 3.945 respectively;
P＝0.005, 0.007, 0.019, 0.036, 0.029 and 0.047 respectively), shorter period of staying in ICU and total length of staying in hospital (Z＝-2.243 and -2.426 respectively, P＝0.019 and 0.015 respectively), and lower medical expenses (Z＝- 2.982, P＝0.003). However, there were no significant differences in in- hospital mortality rate (3.0% vs. 2.9%, P＝1.000) and incidence of infectious pancreatic necrosis (6.1% vs. 23.5%, χ2＝2.766, P＝0.096) between the two groups. Conclusion Early PE may be useful in reducing local complications and organ failure in patients with non-mild hypertriglyceridemic pancreatitis.

Key words: Pancreatitis, Hypertriglyceridemia, Plasma exchange, Clinical outcome