New methods of extracorporeal hemocorrection and detoxification in patients with mechanical jaundice under impaired hepatic function need to be assessed in terms of their effectiveness and safety, especially considering the initial hypocoagulation and the need for heparin. The research aims — to make a comparative assessment of the effectiveness of the selective plasmosorption and plasma exchange under liver failure in patients with mechanical jaundice. Material and methods. The research has been conducted in 32 patients aged 48 to 67 with mechanical jaundice, which developed as a result of cholelithiasis and choledocholithiasis, who had bioliodigestive surgeries. 18 patients underwent selective plasma sorption; 14 patients underwent plasma exchange. The baseline level of total bilirubin ranged from 285 to 589 μmol/l. Selective plasmosorption procedures were performed using the Octo Nova apparatus manufactured by Asahi Kasei Medical (Japan, Germany) with the Plasorba BR-350 sorbent that is developed on the basis of an anion exchange resin for performing plasma sorption. Each patient had three procedures with processing of two volume of plasma circulation per procedure. Herewith, one procedure was performed immediately before the operation, and the other two — in the early postoperative period. The duration of the procedure averaged 4 hours and 05 minutes. The blood flow velocity was 130—160 ml/min. The plasma flow rate was 25—30 ml/min. Before the beginning of the procedure, the lines and the column with the sorbent were rinsed with a solution of heparin 4000 IU per 1 liter of saline. In addition, 5,000 units of heparin were injected intravenously bolus at the beginning of the procedure. Plasma exchange procedures were performed using the USA-manufactured Haemonetics PCS-2 continuous-flow centrifugation machine. Each patient had three procedures with the exfusion of 0.7—1 VCP and the replacement of donor fresh frozen plasma and 5% albumin solution in the ratio 1:1. Anticoagulation — a solution of sodium citrate in the ratio of 1:14 to 1:16. Biochemical indices and coagulogram indices of patients were studied before the procedure, during the procedure and after the procedure. Results. By the end of the procedure there was a significant decrease in the level of total bilirubin after selective plasmosorption by 39.8±3.8%, of conjugated bilirubin by 38.2±18%, of unconjugated bilirubin by 32.5±11.9%, of ALT by 23.5±3. 4%, of AST by 37±2.3%, and of bile acids by 31.4±2.8%. However, other biochemical parameters did not change significantly. The study of the dynamics of hemoglobin and thrombocytes during the treatment did not reveal their decrease. There was no negative dynamics in the change in the international normalized ratio, activated partial thromboplastin time, the level of fibrinogen, prothrombin or antithrombin III. None of the patients had any hemorrhagic complications during the procedure of plasmosorption. In terms of plasma exchange, by the end of the procedure the levels of total bilirubin decreased by 38.5±6.4%, of conjugated bilirubin by 37.2±5.0%, of unconjugated bilirubin by 27.5±2.3%, of ALT by 23.4±4.1%, of AST by 30.4±3.5%, of bile acids by 30.3±5.4%, and of alkaline phosphatase by 34.2±3.5%. Conclusion. The selective plasmosorption and the plasma exchange are effective methods of extracorporeal hemocorrection for patients with mechanical jaundice under liver failure, after which the levels of bilirubin, transaminases and bile acids decrease. The absence of hemorrhagic complications and coarse changes in the coagulogram during the selective plasmosorption and the plasma exchange allows to recommend these extracorporeal hemocorrection methods for patients with a high level of bilirubin in condition of mechanical jaundice at the stages of preparation for the operative resolution of bile duct obstruction and in the early postoperative period. The advantage of the selective plasmosorption over the plasma exchange is noted because there is no need for additional transfusion of the donor plasma, which minimizes the risk of posttransfusion complications.