In a medium cast-iron pan, slowly render the guanciale over medium heat until just starting to get crispy, approximately 5 minutes. Add the sunchokes and celery root and toss to combine. Allow to cook slowly in the rendering fat until cooked through and evenly browned, another 10 minutes.
Meanwhile, put a large, high-sided saute pan over medium heat until hot. Add the clams and Madeira. Immediately cover with a lid and allow to steam until all the clams have opened, about 10 minutes.
Carefully strain the clam cooking liquid into the guanciale pan and bring to a boil. Add the cream, then stir to combine and turn off the heat. Taste and adjust the seasoning as needed with salt.
Combine the clams with the sunchokes and add to a large serving bowl. Garnish with the celery leaves.
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