A four-lumen, 20-F surgical gastrojejunostomy tube designed to incorporate separate lumens for both jejunal feeding and gastric decompression was modified for guide-wire use. This modification permits radiologic rather than intraoperative tube placement. The tube was successfully placed in six patients. Slow gastric leakage that developed at the stoma site in one patient immediately after tube insertion resolved after 24 hours. No catheter dislodgments or other complications occurred. At 4-month follow-up, five patients had fully functional tubes; the sixth patient had died with a functional tube.