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Updated: Feb 9, 2026
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Laparoscopic Pancreatoduodenectomy With Modified Blumgart Pancreaticojejunostomy
Published on: June 17, 2018
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Feeding Advancement and Simultaneous Transition to Discharge (FASTDischarge) after laparoscopic gastrostomy
Richard J Hendrickson1, Ashwini S Poola1, Joseph A Sujka1
1Department of Pediatric Surgery, Children's Mercy Hospital.
Journal of Pediatric Surgery
|June 1, 2018
Summary
A new feeding pathway allows early resumption of feeds and discharge after laparoscopic gastrostomy (LG). This FAST-Discharge protocol enables patients to reach goal nutrition quickly with no complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Nutrition
Background:
- Laparoscopic gastrostomy (LG) is a frequent surgical procedure with no established postoperative feeding guidelines.
- Early feeding resumption and discharge are feasible for patients with prior nasogastric feeding tolerance.
Purpose of the Study:
- To evaluate the safety and efficacy of a novel Feeding Advancement and Simultaneous Transition-Discharge (FAST-Discharge) pathway for pediatric patients undergoing LG.
- To assess the impact of the FAST-Discharge pathway on time to goal nutrition and length of stay (LOS).
Main Methods:
- A retrospective review of 122 pediatric patients who underwent LG between May 2010 and May 2015.
- Patients were outpatients with prior nasogastric feeding tolerance.
- The FAST-Discharge pathway involved initiating feeds within 4 hours postoperatively and advancing as tolerated.
Main Results:
- Initial feeds were started at a median of 2.8 hours post-LG.
- 97% of patients achieved goal nutrition within 24 hours without feed-related complications.
- The median length of stay was 26 hours.
Conclusions:
- The FAST-Discharge pathway is a safe and effective approach for expediting feeding and discharge after LG.
- Early feeding advancement and discharge are associated with a low risk of adverse events in this patient population.
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