1, Diagnostic laparotomy should be performed in all patients with new onset grade 2 to 3 ascites and in patients hospitalized for worsening ascites or who present with other complications of cirrhosis. 2. To rule out bacterial peritonitis, neutrophil counts in ascites should be tested and ascitic fluid cultures inoculated at the bedside. It is important to measure total protein concentration in ascites, as those with a protein concentration <15 g/L in ascites are at increased risk of developing bacterial peritonitis and may benefit from prophylactic antibiotic therapy. 4. A serum-peritoneal fluid-albumin gradient (SAAG) test can be helpful when there is insufficient evidence for a confirmed diagnosis of cirrhosis or when cirrhosis is suspected in combination with other causes of ascites. 5. Because 2 to 3 ascites is associated with decreased survival in patients with cirrhosis, liver transplantation should be considered as a potential treatment option for such patients. Interpretation: Diagnostic laparotomy should be performed in all patients with ascites, and tests related to ascites should be performed according to the condition, and at least 3 cytologic tests should be performed if malignancy is suspected. Since the protein concentration of ascites is closely related to the serum protein concentration, it is inappropriate to infer the presence of portal hypertension by dividing ascites into exudate and leaky fluid based on the protein concentration and relative density of ascites in the past. Prospective studies have demonstrated that the accuracy of diagnosing portal hypertension is 97% when SAAG is >11 g/L.