A retrospective study of 49 patients with hypertriglyceridemic acute pancreatitis (HTG-AP) compared two regimens of therapeutic plasma exchange: centrifugal TPE (cTPE) and membrane TPE (mTPE). Both regimens significantly reduced serum triglyceride (TG) and total cholesterol (TC) levels, with a 66.16% decrease in TG in the cTPE group and a 65.36% decrease in the mTPE group after the first TPE. The decrease in TC was more pronounced in the cTPE group. Both methods resulted in a decrease in platelets (by 11.75% in cTPE and 23.89% in mTPE) but improved coagulation dysfunction. cTPE significantly reduced D-dimer levels and improved patient pH better than mTPE. The cost of one cTPE was lower than mTPE. The study concludes that cTPE has benefits in improving coagulation function and pH, but there is insufficient evidence for its overall superiority; recommended in combination with other therapies.