A 60-year-old male with decompensated cirrhosis presents with refractory ascites despite maximal diuretic therapy (spironolactone 400 mg/day and furosemide 160 mg/day). He has no history of hepatic encephalopathy or variceal bleeding. What is the most appropriate next step in his management?
✓ Correct Answer: Option D
For refractory ascites unresponsive to maximal medical therapy, large volume paracentesis provides temporary relief. However, TIPS placement can reduce portal hypertension and is indicated for patients with refractory ascites who are suitable candidates.