Ascites resistant to medical therapy constitutes a serious complication in cirrhotic patients, and it has a poor quality of life. The insertion of a peritoneovenous shunt is available to refractory ascites, although long-term efficacy is unestablished. Denver peritoneovenous shunt was placed in 8 patients, who were all cirrhotics with hepatocellular carcinoma. The patients included seven males and 1 female and had a median age of 63.4 years. All had previously been treated with vigorous diuretic therapy and repeated paracentesis. Denver shunt was placed between the peritoneal cavity and the subclavian vein. In all patients, abdominal distention disappeared, ascites became controllable, and renal function was improved. Seven patients died; a median survival period was 4.1 months. We believe that refractory ascites in end-stage cirrhotic patients can be successfully treated by the placement of Denver shunt, which often results in relief of the ascites and improvement of quality of life.