Abstract: Objective To investigate the clinical features and influencing factors of pancreatic portal hypertension (PPH). Methods The clinical data of 190 patients with PPH admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2021 to July 2024 were selected as the PPH group, and 190 healthy physical examination patients during the same period were selected as the healthy group. Clinical data of all subjects were collected, the etiology, clinical symptoms, treatment, and prognosis of PPH were analyzed, the clinical data of the PPH group and the healthy group were compared, the influencing factors of the incidence of PPH were analyzed by logistic regression, and a nomogram model was established. Results Among the 190 patients with PPH, the main primary pancreatic diseases were pancreatic tumor in 72 cases (37.89%) and chronic pancreatitis in 50 cases (26.32%). The main clinical symptoms were irregular abdominal pain in 165 cases (86.84%) and solitary fundus varicose veins in 131 cases (68.95%). 121 cases were treated with operation (63.68%), 18 cases were treated with splenic artery embolization (9.47%) and 51 cases were treated with conservative treatment (26.84%). The proportion of pancreatic tumor, acute pancreatitis, serum CRP and FIB in PPH group were higher than those in healthy group (P<0.05). Pancreatic tumors, acute pancreatitis, high levels of CRP, high levels of FIB were independent risk factors for PPH (P<0.05). 380 subjects were divided into the training set and the validation set according to the ratio of 7:3, with 266 in the training set and 114 in the validation set. The AUC (95%CI) of the ROC curve for predicting the incidence of PPH in the training set and the validation set were 0.91 (0.87-0.95) and 0.91 (0.86-0.97), respectively. The correction curve predicted by the nomogram model was close to the ideal curve (P=0.000, 0.148). The DCA curve showed that the probability threshold of the nomogram model at 50% to 100% has a higher positive net benefit. Conclusion The clinical manifestations of PPH are diverse and the pathogenesis is complex. Pancreatic tumor, acute pancreatitis, serum CRP and FIB are the influencing factors of PPH pathogenesis. The constructed nomogram model demonstrated good differentiation, calibration and clinical practicability.

Key words: Pancreatic portal hypertension, Clinical features, Pancreatic tumor, Influencing factors, Nomograph