I'm so sorry your sister in law is going through this. My Mother went through something similar during her battle with this disease. I think the fact that the chemo helped before is a good sign, in that if there is a way for her to re-start the chemo, it may help her. TPN sounds like a good idea too because it can give her the necessary nutrients she will need to not only survive, but also handle the chemo. I just wanted to point out that our oncologist did not let my Mom go on TPN because he said the continuous drainages plus diuretics will cause a lot of fluid imbalance in her body, which could be dangerous. However, if your oncologist is saying it is ok, then it must be fine, but it may be a good idea to double check with her. In the event that she cannot go on TPN, giving her high calorie shakes may be an option if she can tolerate them. My Mom never used the catheters, but she did go in for consistent peritoneal drainages for many months and one lung drainage towards the end of her battle. She also used diuretics for her leg edema, which did help, but it caused massive dry mouth issues. Ascites can be very difficult to deal with and I believe the best shot of getting rid of the ascites is through chemo. I pray that she is able to re-start the chemo soon and feels better. I realize how tough this disease is and I pray also for you and your family to have the ability to stay strong during this difficult time. Please let me know if you have any questions.