Background: Refractory ascites has been treated with peritoneovenous shunts for more than 15 years. Inspite of its role in improving the quality of life, its complications raised questions about its value in treatment of refractory ascites)Objectives: To assess the long term affects of Denver shunt in the management of refractory ascites and in comparison to other methods of treatment, also its indication effectiveness, and complications. Conclusion: PVS,s ( Denver shunt ) has few indications and many complications. It is effective in palliation of refectory ascites and improve quality of life in all most patient but it’s high morbidity and mortality must be carefully weighted against any potential benefit before it’s use .It does not materially affect liver functions and therefore does not improve the overall mortality