How hard/risky is changing an exhaust manifold in the vehicle?

[2003_F350_7.3_Diesel]

Hi All, I have a 2003 F350 with a 7.3. I live in the rust belt. My driver side manifold is horribly rusted and the bolt holding the exhaust pipe is almost gone. Especially because this pipe feeds the turbo if this starts leaking I'm going to have a real problem some day soon. I could try replacing the bolt, but there is not much material left to the manifold so I think I need to replace the manifold. All of the rest of the bolts are similarly rusty. Has anyone changed one of these with the engine in the truck? How big of a job is it? Also Should I go Ford stock manifold, Parts store (Chinese), or something different? I did see one place selling stock manifolds with a ceramic coating on them, any thoughts if this would last up here in the snow & salt? See attached photo of my manifold. It's actually worse than the photo shows.
Thanks!