This paper underscores an enduring principle in cholecystectomy: prioritizing patient safety over procedural completion can prevent injury in difficult cases.

• McElmoyle advocated for preserving adherent tissue and removing the gallbladder only when safely separable, a strategy that echoes modern approaches to subtotal cholecystectomy.
• When visibility is compromised by inflammation, surgeons should recognize that avoiding injury may be more critical than achieving total resection.

Understanding this historical perspective can inform clinical decision-making when faced with challenging gallbladder cases.