When pancreatic cancer causes ascites, particularly a large amount, we can collect the ascites to search for cancer cells. This generally indicates peritoneal metastasis, or metastasis above the liver which can also cause substantial ascites. In such cases, it typically signifies that the disease has progressed to a late stage, classified as stage IV. Patients in this category are unable to undergo surgery and their treatment primarily involves chemotherapy. If the patient's overall condition is good, chemotherapy can be chosen. If the patient's condition is relatively poor, targeted therapy or oral anti-angiogenesis medications may be selected to control the pancreatic cancer and manage the tumor. If the patient's condition is particularly poor, the approach involves placing a peritoneal drainage tube to remove the ascites and providing the best possible symptomatic supportive care.