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As many as 15% of patients with symptomatic cholelithiasis have bile duct stones. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the standard of care for removal of bile duct stones. However, ERCP, especially with sphincterotomy, is associated with risks for bleeding, perforation, and pancreatitis. Endoscopic balloon dilation of the sphincter of Oddi enlarges the orifice for stone extraction without cautery or incision and has been proposed to avoid short- and long-term morbidity associated with sphincterotomy. In a multicenter, prospective trial, investigators randomized 237 sequential patients (median age, 49) with choledocholithiasis to undergo standard ERCP with sphincterotomy or hydrostatic balloon dilatio…