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(1) Background: This study aimed to investigate clinical outcomes for cabozantinib in clinical practice in patients with advanced hepatocellular carcinoma (HCC) previously treated with atezolizumab plus bevacizumab (Atz/Bev), with a focus on whether patients met criteria of Child–Pugh Class A and Eastern Cooperative Oncology Group performance status (ECOG-PS) score 0/1 at baseline. (2) Methods: Eleven patients (57.9%) met the criteria of both Child–Pugh class A and ECOG-PS score 0/1 (CP-A+PS-0/1 group) and eight patients (42.1%) did not (Non-CP-A+PS-0/1 group); efficacy and safety were retrospectively evaluated. (3) Results: Disease control rate was significantly higher in the CP-A+PS-0/1 group (81.1%) than in the non-CP-A+PS-0/1 group (12.5%). Median progression-free survival, overall survival and duration of cabozantinib treatment were significantly longer in the CP-A+PS-0/1 group (3.9 months, 13.4 months, and 8.3 months, respectively) than in the Non-CP-A+PS-0/1 group (1.2 months, 1.7 months, and 0.8 months, respectively). Median daily dose of cabozantinib was significantly higher in the CP-A+PS-0/1 group (22.9 mg/day) than in the non-CP-A+PS-0/1 group (16.9 mg/day). (4) Conclusions: Cabozantinib in patients previously treated with Atz/Bev has potential therapeutic efficacy and safety if patients have good liver function (Child–Pugh A) and are in good general condition (ECOG-PS 0/1).

The diagnosis of bile duct tumors can be difficult at times. A transpapillary bile duct biopsy findings with endoscopic retrograde cholangiopancreatography sometimes contradict diagnostic imaging findings. In bile duct tumors, inflammatory polyps in the extrahepatic bile duct are relatively rare with extrahepatic cholangitis. The disease's clinical relevance, including its natural history and prognosis, is not always clear. We show here a rare case of an inflammatory polyp in the common bile duct. A 69‐year‐old woman with abdominal pain was diagnosed with cholangitis. The findings of contrast‐enhanced computed tomography and magnetic resonance cholangiopancreatography suggested that she had extrahepatic cholangiocarcinoma. The examination and therapy of cholangitis were performed by endoscopic retrograde cholangiopancreatography. The cholangiography revealed a suspected tumor in the hilar bile duct with some common bile duct stones. Then, after endoscopic sphincterotomy to remove tiny common bile duct stones, further detailed examinations were performed at the same time using an oral cholangioscope revealed a papillary raised lesion with a somewhat white surface in the bile duct; a biopsy was conducted on the same spot, and epithelial cells with mild atypia appeared in the shape of a papilla. Since the malignant tumor or the intraductal papillary neoplasm of the bile duct could not be ruled out, extrahepatic bile duct resection was conducted with the patient's informed consent. Bile duct inflammatory polyp was the histopathological diagnosis.

Robotic surgery has technical advantages including high optical magnification and articulation of forceps. However, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. A case of

COVID-19 due to SARS-CoV-2 spread from China in December 2019 and is still a worldwide problem in August 2022. The seventh wave of the epidemic has arrived in Japan, and the number of infected patients is increasing. We report here our experience with a case of COVID-19 1 month after living donor liver transplantation. A 69-year-old female with decompensated cirrhosis due to nonalcoholic steatohepatitis underwent living donor liver transplantation. The donor was her 43-year-old daughter, and the graft was from the right lobe of the liver. The patient had postoperative bile leak and underwent reoperation on postoperative day 4, but otherwise, the postoperative course was generally good. The recipient's blood type was B Rh+ and the donor's blood type was A Rh+. The patient was immunosuppressed with FK, MMF, and steroids after surgery. On postoperative day 32, the patient developed a sore throat, hoarseness, and low-grade fever. PCR test was positive for SARS-CoV-2, and the patient was diagnosed with COVID-19. Respiratory failure was not observed, and the patient was considered mild illness. Remdesivir 200 mg/ day was administered for 3 days, and the dose of MMF was reduced to half. FK and steroids were continued at the same dose, however, FK was measured daily at trough level. Symptoms disappeared 3 days after the onset of the disease, and the trough level of FK passed without significant change. With the spread of COVID-19 infection, the number of cases of COVID-19 after transplantation is likely to increase, and accumulation and analysis of medical data is desirable.