Patients with benign pancreatic disease (chronic pancreatitis, benign tumors) requiring extensive pancreatic surgery are subject to major metabolic changes. Many of them are at risk of developing diabetes. Surgical diabetes is very difficult to manage because of the lack of counter regulation mechanisms. Islet autotransplantation after isolation from the resected pancreas allows to avoid the development of surgical diabetes. Insulin independance can be maintained in 40 to 50% of the patients. Success rate depends on the number of isolated and transplanted islets and on the type of pancreatic disease. Procedures-related complications are rare, the most frequent being thrombosis of the portal vein, through which the islets are transplanted. Islet autotransplantation has been used successfully in chronic pancreatitis and benign tumors.