**Core Concept**
The management of pancreatic ascites involves understanding the pathophysiology of pancreatic fluid leakage and the role of surgical intervention. Pancreatic ascites is the accumulation of pancreatic juice in the peritoneal cavity, often due to a disrupted pancreatic duct.

**Why the Correct Answer is Right**
Surgery is considered in pancreatic ascites when conservative management fails, and there is a significant disruption of the pancreatic duct that needs repair. The goal of surgery is to address the underlying cause, such as a fistula or a leaking pseudocyst, to prevent further leakage of pancreatic juice.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because immediate surgery is not always required.
**Option B:** Incorrect as it does not specify the condition under which surgery should be performed.
**Option D:** Incorrect because it does not consider the failure of conservative management.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that surgery should be considered when there's a failure of medical management and a clear source of leakage that can be surgically corrected.

**Correct Answer:** D. When conservative management fails.