I have a 1993 Plymouth Voyageur, Sorry about being in the Dodge Caravan area but they are pretty much the same.
300,000 km (186000 mi) and generally in great shape, well maintained since new.
Recently had the timeing belt, water pump, valve cover gaskets and cam shaft seals changed due to an oil leak from the cam shaft seals and another 100000 on the timeing belt.
The motor went in running quiet, came out with a tappet noise.
One cam had to be removed to get the seal to seat properly.
It sounds like maybe the lash adjusters were mixed up when reinstalling the rocker arms.
Is this the likley cause for the noisy engine?
Can the lash adjusters be replaced without removing the timeing belt to release pressure on the cam shaft?

 

The answer is yes and no. You will need to remove the timing cover and release the tension on the timing belt, and no you don't need to remove the timing belt.