Review of 54 common duct explorations disclosed that 12 of 30 ducts explored by conventional instrumentation alone contained stones, as did 13 of 24 ducts in which balloon catheters were employed as an adjunct. There were three retained stones in the former group, but minimal morbidity. No residual stones occurred in the latter group, but intrahepatic biliary disruption with sequelae occurred in three instances, hematobilia occurred in one patient, and a fifth patient died of cholangiocarcinoma, five months following balloon-catheter retrieval of biopsy-negative intraductal tissue. Three of the complications which occurred with the balloon-tipped catheter could have been avoided. We conclude that its overall value outweighs the risk of morbidity. Appropriate use of biliary balloon-tipped catheters permits rapid, minimally traumatic exploration of the common duct and significantly lowers the incidence of retained calculi.