Episode # 645 • 15 May 2026
GJ Tubes: Best Practices & Managing Complications
Why are some GJ tubes more prone to failure, and what can you actually do about it? In this episode of the BackTable Podcast, Dr. Chris Beck hosts Dr. Kevin Wong, a pediatric interventional radiologist at the University of South Alabama, to discuss the complexities of gastrojejunostomy (GJ) tube management in hospital-based IR, especially in pediatric patients. The discussion offers clinically relevant guidance on troubleshooting, device selection, and multidisciplinary approaches to enhance GJ tube care and improve patient outcomes.
Timestamps
00:00 - Introduction
05:40 - Etiologies of GJ Tube Dislodgement and Placement Considerations
12:17 - Spiral Upsizing Solutions
14:30 - Parent Education Playbook
19:34 - Indications for GJ Conversion
21:55 - Criteria for GJ Removal
24:12 - Preferred Low-Profile Tube Designs
27:15 - Addressing Suboptimal Angles and Guidewire Selection
31:26 - Strategies to Prevent Tube Occlusion
33:34 - Wish List for Industry
36:12 - Balloon Assisted Placement Techniques
37:58 - Wrap Up and Credits
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More about this episode
The doctors explore why GJ tubes fail and how to manage common complications, such as balloon failures, vomiting-induced dislodgement, stoma enlargement, and recurrent malfunction due to poor gastrostomy angle or architecture, often seen with surgically placed G-tubes. Dr. Wong shares prevention strategies, including parent education on balloon-volume checks and refills, sending patients home with a backup G-tube, minimizing upsizing, and addressing traction and granulation tissue (including the use of silver nitrate). He also covers approaches to clog management such as warm water, Coke, aggressive flushing, and avoiding routing medications through the G port. The episode wraps up with a discussion on device preferences (AMT G-JET versus MIC-KEY), tips for wire and catheter exchanges, and the need for industry improvements in materials and lumen design.
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