Well there's your problem, right there!
All that pile of stuff that came out of your right bank of cylinders and just fell out under the exhaust tip!%);D
Hah! Kidding of course. But about the exhaust, is the rest of the system in as bad (holy) shape as the tips are? If so, you might not be able to tun all the roughness and uneven idling out until you close off some of the leaks.
That's more important the closer to the engine the rust holes get. If it's ok up there, and only rusted through nearer the back of the truck, it's not as big a deal.
But it's still not optimized obviously.
Paul