<prompt> When to do surgery in pancreatic ascites?SymptomaticRecurrent ascites following abdominal drainageNot responding to medical therapyLeak from the stented duct  <response>: PANCREATIC ASCITES: MANAGEMENT Pancreatic ascites occurs from a pancreatic duct disruption or from a leaking pseudocyst. High amylase levels are found in the ascitic fluid. Initial treatment: Non operative elimination of enteral feeding, institution of nasogastric drainage, and administration of somatostatin Repeat paracentesis may also be helpful. Roughly 50 to 60 of patients can be expected to respond to this treatment with resolution of pancreatic ascites within 2 to 3 weeks Persistent or recurrent ascites: Endoscopic or surgical treatment Endoscopic pancreatic sphincterotomy with or without placement of a transpapillary pancreatic duct stent . Resection for leaks in the pancreatic tail or internal Roux-en-Y drainage for leaks in the head and neck region 