Dr. Saleem Ullah Zaffar Gastroenterologist & Hepatologist

06/09/2025

📌 PEG Tube Insertion in a Patient with Oropharyngeal Cancer

Successfully Percutaneous Endoscopic Gastrostomy (PEG) tube insertion in a patient suffering from cancer of the oropharynx who was unable to maintain adequate nutrition due to severe swallowing difficulty.

🔹 Under endoscopic guidance, the PEG tube was safely implanted directly into the stomach.
🔹 The procedure was smooth and well tolerated.
🔹 This feeding tube will now allow the patient to receive proper nutrition and medications, ensuring strength and energy during cancer treatment.

✅ Why PEG in Cancer Patients?
In patients with head & neck cancers, swallowing often becomes extremely difficult. A PEG tube provides a safe and reliable way to maintain nutrition, prevent weight loss, and improve quality of life.

At our center, we remain committed to providing advanced, minimally invasive solutions to support our patients through their toughest journeys. 💙

Appointments @ 03000742259

Dr. Saleem Ullah Zaffar
FCPS (GI), MACG (USA), Post Fellowship in Advance Endoscopy & ERCP
Consultant Interventional Gastroenterologist

31/08/2025

✨ Hope Restored with Esophageal Stenting ✨

A patient came to us with severe difficulty in swallowing due to esophageal cancer. Endoscopy showed a growth inside the food pipe.

✅ We successfully placed a metallic stent to keep the food passage open.
✅ The patient was able to swallow again immediately after the procedure.

💙 Esophageal stenting is a safe and effective way to improve quality of life in advanced esophageal cancer, allowing patients to eat and live more comfortably.

📍 For advanced endoscopic care and compassionate treatment, you can trust us.

📞 Appointment @ 03000742259

Dr. Saleem Ullah Zaffar
Consultant Gastroenterologist & Hepatologist Interventional Endoscopist & ERCP Consultant

19/08/2025

🩺 Advanced GI Care in Action 🩺
Successful ERCP – Even in the Most Challenging Cases

At our practice, we specialize in turning complexity into clarity. Recently, our expert team successfully performed a complex ERCP on a patient with a difficultly positioned ampulla located within a duodenal diverticulum — a scenario that can make access and treatment particularly challenging

✅ Selective CBD cannulation achieved after precise guidewire and sphincterotome manipulation
✅ Filling defects (sludge) identified in the distal common bile duct
✅ Sphincterotomy and balloon sweeps were performed to remove the obstruction
✅ Balloon occlusion cholangiogram confirmed complete clearance
✅ Free bile flow restored
✅ Pancreatic duct preserved – no inadvertent cannulation

💡 Result: The patient left the procedure with restored bile drainage, no residual obstruction, and no complications.

🎯 When it comes to advanced endoscopy, experience matters. Trust your care to a team that handles even the toughest cases with precision and confidence.

📍For Appointment 03000742259.
Saleem Ullah Zaffar
FCPS (GI), MACG (USA), Post Fellowship in Advance Endoscopy & ERCP
Consultant Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Consultant

01/08/2025

🔵 ERCP Case Highlight — Sphincteroplasty & Large CBD Stone Extraction

A middle-aged patient presented with obstructive jaundice and elevated cholestatic liver enzymes. Imaging revealed a dilated CBD with a large distal stone.

🔹 ERCP Procedure Summary:

Duodenum intubated and ampulla identified.

Selective CBD cannulation achieved using guidewire and sphincterotome.

Cholangiogram showed a significantly dilated CBD (~15 mm) with multiple large filling defect consistent with a stones.

Due to the size of the stones, endoscopic sphincteroplasty (balloon dilation up to 15 mm) was performed following limited sphincterotomy.

Multiple balloon sweeps carried out, leading to successful extraction of multiple large pigment stones.

Final occlusion cholangiogram showed clear duct with free bile flow and no residual stones.

✅ Biliary drainage was established
✅ Patient symptoms improved post-procedure

Dr. Saleem Ullah Zaffar
Consultant Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Consultant

Appointments @ 03000742259

01/08/2025

ERCP For Obstructive jaundice / Suspected choledocholithiasis

D2 was approached, and the ampulla of Vater was identified.

Selective cannulation of the common bile duct (CBD) was achieved using a guidewire and sphincterotome.

Contrast dye was injected, revealing multiple small filling defects throughout the CBD, suggestive of stones and sludge.

A standard sphincterotomy was performed.

Multiple balloon sweeps were carried out, resulting in the extraction of three bile duct stones along with a large amount of biliary sludge.

A balloon occlusion cholangiogram was performed, which showed no residual filling defects.

Free flow of bile into the duodenum was observed.

Impression:

Successful CBD cannulation and sphincterotomy.
Three stones and sludge evacuated from the CBD.
No residual stones/sludge on completion cholangiogram.

Good bile drainage achieved.

Dr. Saleem Ullah Zaffar
Consultant Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Consultant

Appointment @ 03000742259

03/06/2025

ERCP for Obstructive Jaundice — 18 Stones Retrieved from common bile duct.

A 47-year-old obese female presented with obstructive jaundice. During ERCP, selective common bile duct (CBD) cannulation was performed. Contrast injection revealed multiple filling defects throughout the CBD.

A wide sphincterotomy was carried out, followed by multiple balloon sweeps — successfully retrieving 18 large bile duct stones.

A final occlusion cholangiogram confirmed a clear CBD with no residual stones.

🟢 Excellent outcome with complete resolution of biliary obstruction.

📍 Dr. Saleem Ullah Zaffar
Consultant Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Specialist

📞 Appointments: 0300-0742259

---

21/05/2025

ERCP for Obstructive Jaundice Due to Impacted CBD Stone

A case of obstructive jaundice due to an impacted stone was successfully managed via ERCP:

Selective common bile duct (CBD) cannulation achieved on the first attempt

Contrast dye revealed a filling defect in the mid CBD

Sphincterotomy performed followed by balloon trawling

A large stone was evacuated successfully

Balloon occlusion cholangiogram confirmed no residual filling defects

Patient experienced immediate relief and improved biliary drainage.

For expert care in advanced endoscopy & ERCP:

Dr. Saleem Ullah Zaffar
FCPS (GI), MACG (USA)
Post Fellowship in Advanced Endoscopy & ERCP
Gastroenterologist, Hepatologist & Interventional Endoscopist

Appointments: 0300-0742259

08/04/2025

ERCP for Post Cholecystectomy SO Stenosis

Selective CBD Cannulation done with guidewire & Sphincterotome in first attempt. Dye injected, which showed small narrowing at the Ampullary region with no residual filling defect in the CBD or IHBD. Balloon trawling resulted in evacuation of clear bile. Occlusion Cholangiogram showed no residual filling defect.

پہلی کوشش میں گائیڈ وائر اور اسفنکٹروٹوم کے ساتھ سلیکٹیو سی بی ڈی کینولیشن کی گئی۔ ڈائی انجیکشن لگایا گیا، جس نے ایمپلیری ریجن میں سی بی ڈی یا آئی ایچ بی ڈی میں کوئی بقایا بھرنے کی خرابی کے ساتھ چھوٹی سی تنگی دکھائی۔ غبارے کے ٹرولنگ کے نتیجے میں صفرا صاف ہو گیا۔ اوکلوژن چولانجیوگرام نے کوئی بقایا بھرنے کی خرابی نہیں دکھائی۔

For Appointment @03000742259

Dr. Saleem Ullah Zaffar
FCPS (GI), MACG (USA)
Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Consultant

24/03/2025

ERCP for Iatrogenic CBD injury, Post cholecystectomy

Selective CBD cannulation achieved with guidewire & Sphincterotome, Dye injected which showed extravasation of contrast from the Cystic stump, balloon trawling revealed clear bile. A straight plastic stent of 10F X12 CM was placed successfully in CBD across the leakage. The patient tolerated the procedure well with no immediate post procedure complications.

Dr. Saleem Ullah Zaffar
Gastroenterologist & Hepatologist
Interventional Endoscopist & ERCP Consultant

Appointment Contact 03000742259
ایٹروجینک سی بی ڈی چوٹ کے لیے ERCP، پوسٹ cholecystectomy

گائیڈ وائر اور اسفنکٹروٹوم کے ساتھ سلیکٹیو سی بی ڈی کینولیشن حاصل کی گئی، ڈائی انجیکشن جس نے سسٹک اسٹمپ سے متضاد اسراف کو ظاہر کیا، غبارے کے ٹرولنگ نے صاف پت کا انکشاف کیا۔ 10F X12 CM کا سیدھا پلاسٹک سٹینٹ CBD میں کامیابی کے ساتھ رساو کے اس پار رکھا گیا تھا۔ مریض نے طریقہ کار کو اچھی طرح سے برداشت کیا جس کے بعد عمل کی کوئی فوری پیچیدگی نہیں تھی۔

ڈاکٹر سلیم اللہ ظفر
معدے کے ماہر اور ہیپاٹولوجسٹ
انٹروینشنل اینڈوسکوپسٹ اور ERCP کنسلٹنٹ

اپوائنٹمنٹ رابطہ 03000742259

07/03/2025

ERCP for Ampullary Stone/ waiting to come out

CBD cannulation done, sphincterotomy resulted in evacuation of stone, balloon sweeps resulted in evacuation of sludge. Free flow of bile was seen.

Dr. Saleem Ullah Zaffar
Consultant Gastroenterologist & Hepatologist
Interventional Endoscopist/ ERCP Consultant

For Appointment 03000742259

24/02/2025

اینڈوسکوپی سے متعلق خرافات کو دور کیا جائے۔

Best Online Doctors - info4patient - Amir AkramPlease subcribe our channel to support our sevices to approach more doctors for Health AwarenessPA Mr. _______...