Hypertriglyceridemia-induced pancreatitis: updated review of current treatment and preventive strategies

Clin J Gastroenterol. 2018 Dec;11(6):441-448. doi: 10.1007/s12328-018-0881-1. Epub 2018 Jun 19.


Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP) comprising up to 7% of the cases. The clinical course of HTG-induced pancreatitis (HTGP) is highly similar to that of AP of other etiologies with HTG being the only distinguishing clinical feature. However, HTGP is often correlated with higher severity and elevated complication rate. At present, no approved treatment guideline for the management of HTGP is available, although different treatment modalities such as insulin, heparin, fibric acids, and omega 3 fatty acids have been successfully implemented to reduce serum triglycerides (TG). Plasmapheresis has also been used to counteract elevated TG levels in HTGP patients. However, it has been associated with complications. Following the management of acute phase, lifestyle modifications including dietary adjustments and drug therapy are essential in the long-term management of HTGP and the prevention of its relapse. Results from studies of small patient groups describing treatment and prevention of HTGP are not sufficient to draw solid conclusions resulting in no treatment algorithm being available for effective management of HTGP. Therefore, prospective randomized, active-controlled clinical studies are required to find a better treatment regimen for the management of HTGP. Until date, one randomized clinical trial has been performed to compare clinical outcomes of different treatment approaches for HTGP. However, further studies are required to outline a generalized and efficient treatment regimen for the management of HTGP.

Keywords: Acute pancreatitis; Heparin; Hypertriglyceridemia; Insulin; Plasmapheresis; Recurrent pancreatitis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Diet, Fat-Restricted
  • Enzyme Activation / drug effects
  • Female
  • Healthy Lifestyle
  • Heparin / therapeutic use
  • Humans
  • Hypertriglyceridemia / complications*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Lipoprotein Lipase / metabolism
  • Pancreatitis / etiology*
  • Pancreatitis / prevention & control
  • Pancreatitis / therapy*
  • Plasmapheresis
  • Pregnancy
  • Pregnancy Complications / therapy


  • Hypoglycemic Agents
  • Insulin
  • Heparin
  • Lipoprotein Lipase