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Methods

Through collaboration with a librarian, we systematically searched Ovid Medline, Embase, the Cochrane Library, Web of Science, and Clinical Trials. gov from inception through November 17, 2017. Google Scholar was also searched. Studies were screened using the web based Covidence software by 2 independent reviewers. We included studies that were randomized trials or cohorts that compared papillary dilation following sphincterotomy to sphincterotomy alone for stones> 1cm in size or those that were characterized as difficult to extract.