Complete control of chylous ascites was achieved by creating a circuit for extracorporeal recirculation of the ascites fluid from the peritoneal cavity to the superior vena cava. A hemofilter was incorporated into the circuit to remove water and electrolytes while returning protein, fat, and white cells. This avoided the associated loss of calories. This system could be applied to other forms of refractory ascites. © 1993 W.B. Saunders Company. All rights reserved.