Weighted Tip Extensions Result in Fewer Gastrojejunostomy Tube Migrations and Increase Tube Lifespan

To investigate the safety and efficacy of attaching a weighted extension to the distal aspect of prefabricated gastrojejunostomy (GJ) tubes, and to determine whether this alteration reduces the occurrences of tip reflux into the esophagus or stomach.

This retrospective 1-way crossover study included 64 GJ tubes in 15 patients placed by multiple operators in the interventional radiology department at a single institution from July 1, 2019, to December 1, 2021. Patients were selected for a weighted tip extension if they required a GJ tube exchange because of the distal tip refluxing into the stomach or esophagus and were aged ≥18 years. These modified GJ tubes were prepared by cutting the distal end of a nasojejunal tube to a length of 10-15 cm and suturing to the distal aspect of the GJ tube.

Of the 64 tubes studied, 37 had a weighted tip extension. The unmodified GJ tubes had a mean lifespan of 34.3 days, which was significantly shorter than the weighted tips (92.8 days; t test P = .001). There was 1 limited adverse event of abdominal pain and spasms that resolved after exchange with a shorter weighted extension.

This study suggests that for patients who require a GJ tube replacement because of the tip refluxing proximally into the stomach or esophagus, the addition of a 10-15-cm weighted extension to the distal end of the GJ tube is safe and significantly improves the lifespan of the enteric tube.